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Spontaneous pneumothorax in children with AIDS
S A Schroeder1, D Beneck, A J Dozor
1Department of Pediatrics, New York Medical College, Valhalla, USA.
Chest
|October 1, 1995
Summary
Spontaneous pneumothorax (SP) is a rare complication in children with advanced HIV infection. This study highlights SP in three pediatric AIDS cases, with varied outcomes after surgical intervention.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Critical Care Medicine
Background:
- Pneumothorax is an uncommon complication in pediatric patients with Human Immunodeficiency Virus (HIV) infection.
- In adults with Acquired Immunodeficiency Syndrome (AIDS), pneumothorax is typically associated with Pneumocystis pneumonia (PCP).
Observation:
- Three children with AIDS presented with spontaneous pneumothorax (SP).
- One child had lymphoid interstitial pneumonitis (LIP), and two had PCP.
- All patients exhibited subpleural cystic lesions and pleural adhesions without typical risk factors for pneumothorax.
Findings:
- Conservative management, including chest tube thoracostomy and chemical pleurodesis, was ineffective.
- Surgical intervention, specifically pleurectomy, resolved pneumothorax in two patients.
- Prognosis varied: patients with PCP did not survive, while the patient with LIP experienced no recurrence after surgery.
Implications:
- This case series suggests a link between specific pulmonary conditions in pediatric AIDS and spontaneous pneumothorax.
- Aggressive management, including surgical options like pleurectomy, may be necessary for managing SP in this population.
- Further research is needed to understand the pathophysiology and optimize treatment strategies for pneumothorax in HIV-infected children.