DOXYCYCLINE PLEURODESIS FOR PNEUMOTHORAX IN PATIENTS WITH AIDS

Since first described in 1984, nontraumatic pneumothoraces in patients with AIDS has become more common. When compared with spontaneous pneu mothorax in the general population, pneumothoraces in patients with AI DS are often complicated by prolonged air leaks as well as higher recu rrence rates. Chemical pleurodesis has an important role in the manage ment of these complications. The most experience with chemical pleurod esis uses tetracycline hydrochloride as the sclerosing agent; however, this agent is no longer available. Doxycycline has been used in pleur odesis of malignant effusions, but its use in managing pneumothoraces is limited. We present five patients who have AIDS with a total of sev en pneumothoraces. Each patient experienced a persistent air leak. Six of the pneumothoraces were managed successfully with doxycycline. Alt hough the follow-up period was limited, there were no recurrences note d and the only side effect seen was chest pain in four which was easil y controlled with narcotics. Doxycycline sclerotherapy can be used eff ectively for pleurodesis in the management of nontraumatic pneumothora x in the patient with AIDS.