2023 Volume 37 Issue 5 Pages 461-465
A caucasian male in his 40s was diagnosed with acquired immunodeficiency syndrome (AIDS) in X-7 following bilateral pneumocystis pneumonia. He was treated with antiretroviral therapy, and was doing well until May X, when he was referred to our department with a diagnosis of first-ever left pneumothorax. Conservative treatment including chest tube drainage failed to achieve complete lung expansion, and thoracoscopic surgery was performed in July X. Preoperative blood tests indicated that AIDS was under good therapeutic control. Intraoperative findings showed air leakage from the apex of the lung and small nodules scattered throughout the visceral and parietal pleura. Partial resection of the left upper lobe and sampling from the parietal pleura were performed. Bacterial culture of the nodules was positive for Achromobacter Sp. Histopathology revealed that the superficial layer of the nodule was covered with mesothelial cells, while the interior layer showed inflammatory cell infiltration and fibroblast proliferation. Although it is known that severe pneumothorax can occur in the acute phase of pneumocystis pneumonia, we encountered a case of pneumothorax in the late phase with a good course of treatment. Opportunistic pleural infection with Achromobacter Sp. was considered as a possible cause.
