Bronchoalveolar lavage neutrophilia seen in Pneumocystis pneumonia presenting with pneumothorax

Spontaneous pneumothorax is a known complication of Pneumocystis carinii pneumonia (PCP) in patients with acquired immunodeficiency syndrome. From a series of 61 patients with PCP, we identified two cases, not associated with aerosolized pentamidine, that presented with spontaneous pneumothorax and cystic changes seen on chest radiographs. Bronchoalveolar lavage cell findings were remarkable for very elevated neutrophil counts in both cases, suggesting a possible inflammatory cause for the observed cystic changes.