Cavitary Pneumocystis carinii pneumonia in patients receiving aerosol pentamidine prophylaxis

We have described two patients with AIDS who had cavitary Pneumocystis carinii pneumonia while receiving aerosolized pentamidine prophylaxis. This is the first report of this complication. Neither patient showed a clinical response to subsequent use of pentamidine either intravenously or by aerosol followed by intravenous use. Clinicians should be aware of the possibility that cavitary pneumonia in patients receiving aerosolized pentamidine may be due to P carinii.