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Pneumocystis carinii pneumonia with pleurisy, platypnoea and orthodeoxia
  1. P N Newton1,
  2. A E Wakefield2,*,
  3. R Goldin3,
  4. J Govan1
  1. 1Hillingdon Hospital, Hillingdon, Uxbridge UB8 3NN, UK
  2. 2Molecular Infectious Diseases Group, Department of Paediatrics, Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK
  3. 3Department of Histopathology, St Mary’s Hospital, London W2 1PG, UK
  1. Correspondence to:
    Dr P N Newton, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK; newtonpaul100{at}hotmail.com

Abstract

We present a patient who collapsed with chest pain and dyspnoea on a transatlantic flight. She was found to have Pneumocystis carinii pneumonia (PCP) and human immunodeficiency virus infection. Platypnoea and orthodeoxia, which have not been previously reported in association with PCP, were major features of her illness. The PCP predominantly affected her lung bases and it is likely that gravity increased intrapulmonary blood flow through poorly ventilated lung bases with failure of pulmonary vasoconstriction to increase upper zone perfusion, exacerbating desaturation on sitting up. The partial DNA sequence of the infecting P carinii was identical to previously described isolates.

  • Pneumocystis carinii pneumonia
  • human immunodeficiency virus
  • platypnoea
  • orthodeoxia
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  • * Deceased

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