Surgical management of pneumothorax in patients with acquired immunodeficiency syndrome
A. N. Gerein, M. L. Brumwell, L. M. Lawson, N. H. Chan and J. S. Montaner
Department of Surgery, University of British Columbia, Vancouver, Canada.
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.
