Pneumomediastinum in patients with AIDS: A case report and literature review

Abstract

Objective: Pneumomediastinum is a rare complication of opportunistic infections in HIV-infected patients. However, the relationship between the causative pathogens and the prognosis is unclear. We report the case of a patient with AIDS presenting with community-acquired pneumonia complicated by pneumomediastinum. The cases of a further 10 HIV-infected patients with pneumomediastinum reported in the English language literature are reviewed. Methods: PubMed was searched for cases of HIV-infected patients with pneumomediastinum published in the English language literature. Results: Pneumocystis jirovecii is the most common pathogen causing pneumonia and concurrent pneumomediastinum in HIV-infected patients. Only one of the identified cases was caused by cytomegalovirus. Excluding the two cases with incomplete information, the overall mortality rate in the remaining nine cases was 55.5%. Conclusion: In HIV-infected patients, Pneumocystis jirovecii pneumonia can occasionally present as pneumomediastinum. In such cases, adequate appropriate antimicrobial therapy is needed due to the high mortality rate. © 2014 The Authors.