SEVERE CYSTIC PULMONARY-DISEASE ASSOCIATED WITH CHRONIC PNEUMOCYSTIS-CARINII INFECTION IN A CHILD WITH AIDS

A 3-year-old HIV-positive boy developed Pneumocystis carinii pneumonia (PCP) resulting in chronic interstitial pulmonary disease, which pers isted for the following 3 years; he was essentially asymptomatic and t he lung findings had therefore been attributed to lymphocytic intersti tial pneumonia (LIP). He subsequently developed extensive cystic pulmo nary disease, documented by CT, leading to recurrent pneumothorax and severe pulmonary insufficiency. Lung biopsy revealed chronic PCP infec tion associated with extensive pulmonary fibrosis and calcification. T his case suggests that Pneumocystis carinii may cause chronic progress ive pulmonary fibrosis with cyst formation and respiratory failure.