Pneumocystis carinii pneumonia is a severe and potentially fatal infection that commonly occurs in the immunosuppressed or congenitally immunodeficient child. Previously reported unusual roentgenographic manifestations of this disease have included pleural effusions, emphysema, pneumothorax, pneumomediastinum, lobar consolidation, and nodular densities.1.2.3 This report describes the occurrence of multiple large pneumotoceles in a child with P carinii pneumonia.
Report of a Case.—An 8-year-old girl had acute lymphoblastic leukemia in March 1973. Complete remission was achieved with prednisone and vincristine sulfate. After central nervous system prophylactic treatment, remission was maintained with mercaptopurine riboside, methotrexate, and cyclophosphamide.
Two years after her initial diagnosis, she was admitted to the University of Maryland Hospital because of fever, nonproductive cough, and a respiratory rate of 48/min. Chest roentgenograms demonstrated diffuse bilateral interstitial infiltrates. Her dyspnea gradually increased, and there was progression of the interstitial infiltrate. Multiple cultures of blood and sputum showed no pathogens.