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Epidural Pneumatosis Complicating Pneumocystis jiroveci Pneumonia in a Patient With AIDS

Tomal, Justin BA; Shah, Nirav MD, MPH; Schneider, John MD, MPH

Infectious Diseases in Clinical Practice: July 2014 - Volume 22 - Issue 4 - p e44–e46
doi: 10.1097/IPC.0b013e3182948e8f
Case Reports

Abstract: Here, we report what is to our knowledge the first documented case of epidural pneumatosis in the setting of Pneumocystis jiroveci pneumonia. Epidural pneumatosis is defined by air in the epidural space. Its common pathophysiologic development is from air leaking from pneumomediastinum through intervertebral foramina, although other mechanisms exist. Our patient, an 18-year-old man with acquired immunodeficiency syndrome, developed a striking epidural pneumatosis with associated pneumomediastinum as a complication of P jiroveci pneumonia. He was treated successfully with trimethoprim-sulfamethoxazole and prednisone, and he experienced no sequelae from the epidural pneumatosis. In fact, epidural pneumatosis generally is regarded as a benign phenomenon.

From the Section of Infectious Diseases, Department of Medicine, University of Chicago, Chicago, IL.

Correspondence to: Justin Tomal, BA, Section of Infectious Diseases, Department of Medicine, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637. E-mail: jtomal@uchicago.edu.

The authors have no funding or conflicts of interest to disclose.

© 2014 by Lippincott Williams & Wilkins.