Disseminated infection with Pneumocystis carinii related to administration of pentamidine aerosol

To the Editor. — A controlled clinical trial including 408 patients at 12 treatment centers was initiated in 1987 to assess the efficacy of aerosolized pentamidine for the prophylaxis of Pneumocystis carinii pneumonia. 1 This study is of great importance, because in patients with acquired immunodeficiency syndrome (AIDS), P carinii continues to be the most common pathogenic agent with an incidence of 60% at presentation, causing severe life-threatening infections. The results of the prophylaxis trial recently published in the New England Journal of Medicine show that aerosolized pentamidine administered to patients infected with human immunodeficiency virus was beneficial in preventing P carinii pneumonia in proportion to dose and schedule of administration. 1 While pneumonia is by far the most common manifestation of the P carinii infection in AIDS, sporadic cases of extrapulmonary or disseminated pneumocystosis, in addition to the pulmonary localization, have been reported. 2-6 Several of them occurred in