Intravascular and Pleural Involvement by Pneumocystis carinii in a Patient With the Acquired Immunodeficiency Syndrome (AIDS)

<i>Pneumocystis carinii</i> Infections in HIV-lnfected Hemophiliacs during Aerosolized Pentamidine Prophylaxis

“…Ruptured apical cysts or bronchopleural fistulae after subpleurai necrosis may then result in pneumothorax. Our observation of Pneumocystis pleuritis is a further support for the concept of atypical pneumocystosis during AP as a result of con version of a diffuse into a localized disease [3]. It is also supported by our observation of a cavitation developing in an upper-lobe infiltrate.…”

Parasitic Infections of the Pleural Space

“…Although recent data indicate that the ribosomal RNA sequence of Pneumocystis carinii corresponds more closely to that of fungi than protozoa, it is still widely considered a protozoan because of its morphologic resemblance to these parasites. [114][115][116][117][118] We have, therefore, chosen to discuss it in this review. Our appreciation of "atypical" pulmonary, pleural, and extrathoracic manifestations produced by this unusual organism has grown over the past 2 decades, in large part a reflection of the spreading acquired immunodeficiency syndrome (AIDS) epidemic.…”

“…114 More recently, there have been a number of articles describing the appearance of thin-walled cysts, multiple cavitary lesions, and repetitive bouts of pneumothoraces in patients with AIDS presenting with proven PCP. [115][116][117][118] These lesions were thought to reflect destruction of lung tissue, perhaps secondary to the chronic nature of the infection in such patients, ongoing activation of macrophages and subsequent elastase production. 115 DeLorenzo and coworkers 116 noted cystic lesions in 7 of 104 patients with AIDS and PCP; in the majority, the cysts were present before the patient was exposed to positive airway pressure.…”

“…Six of their patients developed spontaneous pneumothoraces during the course of their illness. 116 Dyner and colleagues, 118 noting the presence of P. carinii organisms in the pleura, raised the possibility that aerosolized pentamidine might effectively inhibit pulmonary, but not pleural organisms.…”

Benefits of sulfamethoxazole‐trimethoprim prophylaxis on rates of sepsis after kidney transplant

“…Post‐transplant infectious disease guidelines recommend prophylaxis with SMX/TMP or an alternative for 6–12 months post transplantation for the prevention of PCP . PCP is a significant concern in patients receiving long‐term corticosteroid maintenance therapy because of the high mortality associated with its presentation ; additionally, >30% of PCP cases occur after the first year following solid organ transplantation in patients not receiving prophylaxis, demonstrating that the optimal duration of prophylaxis is unknown . Furthermore, a recent increase has been seen in the number of late cases of PCP reported in the transplant literature in patients not receiving prophylaxis .…”