[Nodular and cavitary pneumocystosis in a patient with hemophilia A and the acquired immunodeficiency syndrome].

A 25-year-old man with hemophilia A who had received concentrated plasma and plasma factor VIII products since childhood presented with a productive cough and a fever. The CD4/CD8 ratio of peripheral lymphocyte subsets was very low and the serum was positive for anti-HIV antibodies. The chest roentgenogram showed bilateral multiple nodules with cavity formation. The patient underwent transbronchial lung biopsy, and the specimen obtained had Pneumocystic carinii organisms. The patient was treated with sulfamethoxazole and trimethoprim compounds, and with inhaled pentamizine. His condition improved. Patients with pulmonary pneumocystosis usually present with interstitial infiltrates spreading from the hilium to the periphery of the lungs, and nodular and cavitary lesions are unusual pulmonary radiographic findings in this condition.