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- Pneumothorax (PTX) defined by air in pleural space, either due to entry from outside chest wall or leakage from lung parenchyma.
- In HIV, occurs most often in setting of Pneumocystis pneumonia (PCP). Spontaneous PTX in AIDS pt should prompt workup for PCP.
- PCP-associated PTX independently associated with greater mortality.
- Spontaneous PTX in pts with AIDS can also occur with TB, COPD, pulmonary cryptococcosis, coccidioidomycosis , and lymphoid interstitial pneumonitis.
- Iatrogenic causes: central venous line placement, thoracentesis, bronchoscopy, liver Bx
- Presenting Sx: pleuritic chest pain, dyspnea, cough
- PE: Tachycardia, tachypnea, hypoxia, hyper-resonance or decreased breath sounds over one lung field. Some pts may not have any signs or Sx beyond those of pneumonia.
- Higher incidence in males, cigarette smokers, pts on aerosolized pentamidine prophylaxis, pts w/ pneumatoceles on CXR, injection drug users, pts on mechanical ventilation.
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Last updated: September 3, 2015
Gallant, Joel E, and Patrick R Sosnay. "Pneumothorax." Johns Hopkins HIV Guide, 2015. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545166/all/Pneumothorax.
Gallant JE, Sosnay PR. Pneumothorax. Johns Hopkins HIV Guide. 2015. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545166/all/Pneumothorax. Accessed December 14, 2019.
Gallant, J. E., & Sosnay, P. R. (2015). Pneumothorax. In Johns Hopkins HIV Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545166/all/Pneumothorax
Gallant JE, Sosnay PR. Pneumothorax [Internet]. In: Johns Hopkins HIV Guide. ; 2015. [cited 2019 December 14]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545166/all/Pneumothorax.
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