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Pneumocystis jirovecii pneumonia (PJP) is one of the most common causes of respiratory failure in patients with human immunodeficiency virus (HIV) infection, for which the mortality rate is approximately 10%. Spontaneous pneumothorax as a presentation of PJP has been reported with rising frequency, but tension pneumothorax as a presentation of PJP...
Contexts in source publication
Context 1
... surgery team placed a chest tube; however, the patient's symptoms did not improve, and the decision was made to intubate him and transfer to the medical intensive care unit. Chest Xray following the chest tube placement was demonstrated in Figure 2, which showed resolution of the pneumothorax. ...
Context 2
... surgery team placed a chest tube; however, the patient's symptoms did not improve, and the decision was made to intubate him and transfer to the medical intensive care unit. Chest Xray following the chest tube placement was demonstrated in Figure 2, which showed resolution of the pneumothorax. ...
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Background: We performed a meta-analysis to systematically review the risk factors of mortality from non-HIV-related Pneumocystis pneumonia (PcP) and provide the theoretical basis for managing non-HIV-related PcP.
Methods: PubMed, Embase, Web of Science, the Cochrane Library and CNKI databases were searched. A meta-analysis of the risk factors of m...
Citations
... Cystic lung disease, often multiple and bilateral, are often found in these cases of PJP [14] . PJP may cause pneumothorax via lung pneumatocele formation, local subpleural necrosis, or interstitial inflammation leading to fibrosis [15] . Nodules with varying appearance, including cavitation or calcification can occur as a rare manifestation [14] . ...
A 48-year-old male presented with spontaneous pneumothorax requiring chest tube placement in the setting of COVID-19 infection. CT chest revealed bilateral ground-glass opacities and multiple, large, gas-filled, cavitary lesions in the lungs bilaterally. These imaging findings led to an initial HIV diagnosis with the patient presenting at a CD4+ count of <32 cells/µL. He was found to additionally have infections with Mycobacterium kansasii, cytomegalovirus, Pneumocystis jirovecii, and Candida albicans. After developing worsening hypoxic respiratory failure, he developed additional pneumothoraces bilaterally, requiring repeated chest tube placement. He was treated with antimicrobial therapy for his underlying infections and subsequently started on combined antiretroviral therapy.
... Pneumoscrotum is a potential complication of advanced Pneumocystis jirovecii pneumonia (PJP) in which spontaneous pneumothoraces can occur [2] [3]. ...
... Unfortunately, in the case of our patient, end stage lung disease prevented reversal of the diffuse subcutaneous emphysema. In later stages of PJP, with severe inflammation of the lung tissue, the normal parenchyma can be replaced by pneumatoceles and cysts-which promote the occurrence of spontaneous pneumothorax [3]. Despite lengthy treatment for PJP, the patient's respiratory condition deteriorated following prolonged positive-pressure mechanical ventilation. ...
... Another involves severe inflammation and fibrosis from PCP leading to lung contractures, with slow leakage of air from visceral pleura to the pleural space. 13 Pneumomediastinum in PCP is likely related to cyst rupture, and occurs from free air leak from ruptured alveoli tracking along the pulmonary vessels and the interstitium to the hilum. 14 The incidence of spontaneous pneumothorax and pneumomediastinum is estimated to be between 0.4-4% in non-HIV individuals; co-occurrence is rare in the same individual. ...
We report a case of Pneumocystis jirovecii pneumonia (PCP) complicated by bilateral pneumothoraces and pneumomediastinum in a non-human immunodeficien-cy virus (HIV)-infected patient. This unusual presentation exemplifies the differences in clinical course and presentation in non-HIV versus HIV-infected individuals, and the poor prognosis associated with PCP complicated by pneumothorax or pneumomediastinum. Providers should be aware of the high mortality in patients who develop one, and especially both complications.
