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Alfred N. Gerein, MD; Mary Lynn Brumwell, MD; Lindsay M. Lawson, MD; Norman H. Chan, MD; Julio S. G. Montaner, MD

Arch Surg. 1991;126(10):1272-1277.

Abstract
• Pneumocystis carinii pneumonia in a patient with acquired immunodeficiency syndrome may cause severe alveolar damage, resulting in pneumothoraces that are often bilateral, recurrent, and refractory to accepted methods of treatment. The clinical features, management, and follow-up results were assessed in 22 consecutive patients who presented with a pneumothorax and acquired immunodeficiency syndrome. Seventeen patients died within the time frame of this study. Their average survival time was 147 days. Five surviving patients have lived an average of 366 days. We proposed an algorithm to assist in the management of pneumothoraces in these patients. We concluded that pneumothorax in patients with acquired immunodeficiency syndrome is prognostic of short-term survival. The results in the treatment of pneumothorax in the patient with acquired immunodeficiency syndrome are related to the pathologic lesions of the lung that are associated with Pneumocystis pneumonia and not to the surgical treatment that is employed.

(Arch Surg. 1991;126:1272-1277)

Author Affiliations
From the Departments of Surgery (Drs Gerein and Brumwell), Medicine (Drs Lawson and Montaner), and Pathology (Dr Chan), University of British Columbia and St Paul's Hospital, Vancouver.

Footnotes
Accepted for publication June 30, 1991.

Read before the 62nd Annual Scientific Session of the Pacific Coast Surgical Association, Pebble Beach, Calif, February 20, 1991.

Reprint requests to Third Floor Respiratory Clinic, St Paul's Hospital, 1081 Burrard St, Vancouver, British Columbia, Canada V6Z 1Y6 (Dr Gerein).

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