GRANULOMATOUS PNEUMOCYSTIS-CARINII IN AIDS PATIENTS

Seven cases of Pneumocystis carinii pneumonia with granulomatous react ion in patients infected with the human immunodeficiency virus are des cribed. The patients were all adult men between the ages of 32 and 45 years, with different high-risk factors. Clinically, all the patients presented with a history of non-productive cough and shortness of brea th. Two of the patients had a past history of pulmonary pneumocystosis . Radiologically, six patients had diffuse pulmonary infiltrates and o ne nodular pulmonary infiltrate. Transbronchial lung biopsies were obt ained in four patients and open lung biopsies in three. All presented a predominant granulomatous reaction composed of epithelioid and multi nucleated giant cells. Several other special stains to detect the pres ence of other microorganisms to account for the granulomatous reaction were negative.