Forty eight patients withtheacquired immunedeficiency syndrome (AIDS)presented totheMountSinai Hospital inNewYorkwithpersistent coughanddyspnoea or an abnormal chest radiograph, orboth. Thirty two(67%) were found tohavePneumocystis carinii pneumonia, either alone or incombination withanother pathogen. Ofthese patients, eight (25%)hada normal chest radiograph. Abnormalities inthesingle breath carbon monoxide diffusing capacity andalveolar-arteria l oxygen gradient ((A-a) Do2)suggested infection withPneumocystis carnii. Fibreoptic bronchoscopy withtransbronchial biopsy was 100%sensitive inthediagnosis of pneumocytis pneumonia. Fibreoptic bronchoscopy should beundertaken inpatients suspected of having a pulmonary complication ofAIDS,even ifthechest radiograph isnormal. Theacquired immunedeficiency syndrome (AIDS) ischaracterised byanunusually aggressive formof Kaposi's sarcoma, Pneumocystis carinii pneumonia, orother life threatening opportunistic infection in patients whoareunder theageof60andwhohave noprevious history ofeither illness ortreatment causing immunosuppression.'
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