[Extrapulmonary manifestations of Pneumocystis carinii infection in AIDS]

Between 1986 and 1990 we found in 7 out of 100 continuously performed AIDS-autopsies at Auguste-Viktoria-Hospital (AVH) an extrapulmonary manifestation of Pneumocystis carinii (Pc). 4 of these cases showed only a singular infiltration of pulmohilar lymphnodi, while the remaining 3 cases presented various other organ involvements: spleen, liver, kidney, adrenal gland, prostate gland, pancreas, myocardium, thyroidea and eyes. All these AIDS-patients had a chronic or relapsing Pc-pneumonia with focal interstitial fibrosis, emphysema, and cavernous-cystic lesions. 6 patients developed a spontaneous pneumothorax due to ruptured subpleural bullae or cystic changes. Apparently the rare dissemination of Pc develops in the context of ruptured tissue and vessels in the pneumothorax lung of AIDS-patients during the final stage of the immunodeficiency associated with chronic lung changes.