Pneumocystis carinii pneumonia in homosexual men

The clinical records and radiographs of 12 homosexual men with symptomatic biopsy-proved Pneumocystic carinii pneumonia were reviewed. At presentation, the most common radiographic finding in the chest was a diffuse, coarse, ground-glass pattern. Normal findings on chest radiographs or only minimal abnormalities did not preclude P. carinii pneumonia. Progression of the radiographic findings varied. Rapid development of diffuse consolidation in 2--5 days occurred most commonly. Thoracic lymphadenopathy and pleural effusions were each seen in two patients. Clearing of the lungs often took many weeks. Six of the 12 patients died in 2 weeks to 8 months. In the appropriate clinical setting, early transbronchial biopsy should be strongly advocated to ensure initiation of suitable antimicrobial therapy.