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Granulomatous Pulmonary Lesions in Patients with the Acquired Immunodeficiency Syndrome (AIDS) and Pneumocystis carinii Infection

Walter Blumenfeld, MD; Nesli Basgoz, MD; William F. Owen Jr., MD; and Drago M. Schmidt, MD
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Current Author Addresses: Drs. Blumenfeld and Basgoz: Veterans Administration Medical Center, 4150 Clement Street, Department of Clinical Pathology, 113A, San Francisco, CA 94121.

Drs. Owen and Schmidt: St. Luke's Hospital, 3555 Army Street, San Francisco, CA 94110.

Ann Intern Med. 1988;109(6):505-507. doi:10.7326/0003-4819-109-6-505
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This excerpt has been provided in the absence of an abstract.

Pneumocystis carinii is the commonest opportunistic infection in patients with the acquired immunodeficiency syndrome (AIDS). Its clinical and pathologic features have been well described (1-3). We describe two patients with atypical granulomatous pulmonary manifestations of P. carinii. Both patients had initial episodes of P. carinii pneumonia and were treated. They subsequently received zidovudine and aerosolized pentamidine.

Case 1

A 38-year-old man with a 6-month history of AIDS presented with 1 week of nausea, fever, slight cough, and dyspnea. The patient had been treated for cytomegalovirus retinitis with ganciclovir, which was discontinued because of severe neutropenia. At the same time, he


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