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Open Access Highly Accessed Case report

Newly formed cystic lesions for the development of pneumomediastinum in Pneumocystis jirovecii pneumonia

Ju-Yeon Cho, Dong-Min Kim*, Yong Eun Kwon, Sung Ho Yoon and Seung Il Lee

Author Affiliations

Department of Internal Medicine1, Chosun University, College of Medicine, Republic of Korea

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BMC Infectious Diseases 2009, 9:171  doi:10.1186/1471-2334-9-171

Published: 18 October 2009



Pneumocystis jirovecii, formerly named Pneumocystis carinii, is one of the most common opportunistic infections in human immunodeficiency virus (HIV)-infected patients.

Case presentations

We encountered two cases of spontaneous pneumomediastinum with subcutaneous emphysema in HIV-infected patients being treated for Pneumocystis jirovecii pneumonia with trimethoprim/sulfamethoxazole.


Clinicians should be aware that cystic lesions and bronchiectasis can develop in spite of trimethoprim/sulfamethoxazole treatment for P. jirovecii pneumonia. The newly formed bronchiectasis and cyst formation that were noted in follow up high resolution computed tomography (HRCT) but were not visible on HRCT at admission could be risk factors for the development of pneumothorax or pneumomediastinum with subcutaneous emphysema in HIV-patients.