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April 2, 1982

Pneumocystis carinii Pneumonia in a Previously Healthy Adult

JAMA. 1982;247(13):1860-1861. doi:10.1001/jama.1982.03320380052029

THE OCCURRENCE of Pneumocystis carinii pneumonia in normal adults has been reported only rarely; it is almost exclusively a disease of immunocompromised hosts.1 A case of a previously healthy adult with fatal P carinii pneumonia, documented by open lung biopsy and necropsy, who was treated unsuccessfully with trimethoprim-sulfamethoxazole and pentamidine isethionate, is presented.

Report of a Case  A 38-year-old homosexual man was in excellent health until July 1980, two months before admission to the hospital, when recurrent sore throats, anorexia, and dyspnea began. These symptoms continued; one week before admission, fever, night sweats, headache, and a nonproductive cough developed. Progressive fever to 39.4 °C, substernal chest pain, and dyspnea on minimal exertion led to his admission. No coryza, myalgias, arthralgias, or mental changes were noted.The patient appeared ill; respirations were 36/min; pulse rate, 88 beats per minute; and temperature, 40.3 °C. Results of the physical examination were otherwise