title: Pneumomediastinum in patients with AIDS: a case report and literature review.
abstract: OBJECTIVE
  Pneumomediastinum is a rare complication of opportunistic infections in HIV-infected patients. However, the relationship between the causative pathogens and the prognosis is unclear. We report the case of a patient with AIDS presenting with community-acquired pneumonia complicated by pneumomediastinum. The cases of a further 10 HIV-infected patients with pneumomediastinum reported in the English language literature are reviewed.
  
  
  METHODS
  PubMed was searched for cases of HIV-infected patients with pneumomediastinum published in the English language literature.
  
  
  RESULTS
  Pneumocystis jirovecii is the most common pathogen causing pneumonia and concurrent pneumomediastinum in HIV-infected patients. Only one of the identified cases was caused by cytomegalovirus. Excluding the two cases with incomplete information, the overall mortality rate in the remaining nine cases was 55.5%.
  
  
  CONCLUSIONS
  In HIV-infected patients, Pneumocystis jirovecii pneumonia can occasionally present as pneumomediastinum. In such cases, adequate appropriate antimicrobial therapy is needed due to the high mortality rate.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Wan-Ling
authors.initials: WL
authors.lastname: Cheng
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan.
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Nan-Yao
authors.initials: NY
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan.
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Chang
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Ching-Chi
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Ming-Chi
authors.initials: MC
authors.lastname: Li
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital and Medical College, No. 138, Sheng Li Road, 704, Tainan, Taiwan; Center for Infection Control, National Cheng Kung University Hospital, Tainan, Taiwan. Electronic address: li.cw29@gmail.com.
authors.forename: Chia-Wen
authors.initials: CW
authors.lastname: Li
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D045363:Pneumocystis carinii / Q000302:isolation & purification / Q000502:physiology; D011014:Pneumonia / Q000188:drug therapy / Q000473:pathology* / Q000821:virology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents
keywords: HIV; Pneumocystis jirovecii; Pneumomediastinum; Pneumonia