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Chest, Vol 94, 329-331, Copyright © 1988 by American College of Chest Physicians

ARTICLES

Bilateral upper lobe Pneumocystis carinii pneumonia in a patient receiving inhaled pentamidine prophylaxis

AG Abd, DM Nierman, JS Ilowite, RN Pierson Jr and AL Bell Jr
Department of Medicine, St. Luke's Roosevelt Hospital Center, New York.

A 46-year-old man with AIDS, receiving inhaled pentamidine for Pneumocystis carinii pneumonia (PCP) prophylaxis, developed bilateral upper lobe infiltrates. Bronchoalveolar lavage confirmed the diagnosis of PCP. Therapy with intravenous trimethoprim-sulfamethoxazole (TMP- SMX) was begun, with gradual resolution of these infiltrates noted. An explanation for the development of upper lobe PCP, despite aerosol chemoprophylaxis, is presented and emphasizes the importance of aerosol particle size (and therefore of nebulizer type) on the distribution of inhaled pentamidine.


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J. L. Brusch and E. J. Mark
Case 34-1993- A 36-Year-Old Man with AIDS and Respiratory Failure
N. Engl. J. Med., August 26, 1993; 329(9): 645 - 653.
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Copyright © 1988 by the American College of Chest Physicians.