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Pneumothorax as the presenting sign ofPneumocystis carinii infection in an HIV-positive child with prior lymphocytic interstitial pneumonitis
Authors:K. Sack Solomon  T. L. Levin  W. E. Berdon  B. Romney  C. Ruzal-Shapiro  M. R. Bye
Affiliation:(1) Department of Radiology, Division of Pediatric Radiology, Babies & Children's Hospital of New York, Columbia-Presbyterian Medical Center, 3959 Broadway, BHN 3-318, 10032 New York, NY, USA;(2) Department of Pediatrics, Babies and Children's Hospital of New York, Columbia-Presbyterian Medical Center, New York, USA
Abstract:An HIV-positive child presented with a pneumothorax secondary to cavitaryPneumocystis carinii pneumonia (PCP). Lymphocytic interstitial pneumonitis had been evident on earlier radiographs but had resolved, concurrent with a decrease in her CD4 counts, before the radiographic changes of PCP became evident. As immune function declines in HIV-positive children, the chest radiograph may paradoxically clear. In such a setting, development of focal lung disease, including pneumothorax, may heraldPneumocystis carinii infection.
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