Purpose: To determine the incidence of acute
respiratory failure (ARF) in non-AIDS patients with pulmonary
Design: Retrospective cohort
Setting: University of Pittsburgh Medical
Center, Pittsburgh, PA.
Subjects: All patients in whom
PC without HIV infection was diagnosed between February 1989 and March
Results: Thirty-three patients with PC were
identified, and 11 of those patients (33%) developed ARF and comprised
the study group. Underlying diseases included solid-organ transplant
recipients (seven patients; 64%) and other underlying medical
conditions (four patients; 36%). The most common symptoms were cough,
shortness of breath, and temperature elevation. Extrapulmonary
involvement was seen in six patients (meningitis, four patients;
peritonitis, one patient; laryngeal mass, one patient). Six of the 11
patients (55%) died.
Conclusion: ARF may develop in
one third of non-AIDS patients with PC. This clinical syndrome is
associated with the dissemination to extrapulmonary sites and high
mortality rates. PC should be recognized as a possible cause of
respiratory failure in non-AIDS patients.