Maternal–Fetal Transmission of Pneumocystis carinii In Human Immunodeficiency Virus Infection

Abstract

A case is reported in a 33-yr-old HIV-positive pregnant woman from France who presented with a 15-d history of fever, non-productive cough and dyspnoea. Chest radiography revealed diffuse bilateral interstitial infiltrates and bronchoalveolar lavage showed P. carinii cysts. Despite therapy with trimethoprim-sulfamethoxazole the patient developed respiratory failure and required mechanical ventilation. The patient delivered a dead fetus 3 wk later and died of refractory hypoxaemia the following day. Post-mortem examination of the fetus revealed P. carinii cysts in intra-alveolar macrophages which were not found within eosinophilic foamy intra-alveolar exudate, and there was no associated interstitial pneumonia, indicating a limited primary P. carinii infection.