Bleomycin sclerotherapy for bilateral pneumothoraces in a patient with AIDS

Spontaneous pneumothorax has been reported in patients with the acquired immunodeficiency syndrome (AIDS). We report a case of a patient with AIDS and Pneumocystis carinii pneumonia whose course was complicated by bilateral pneumothoraces that were refractory to usual therapy. After several attempts at tetracycline pleurodesis had failed, bilateral bleomycin sclerotherapy proved successful. We conclude that effective nonsurgical control of recurrent spontaneous pneumothoraces may be achieved with bleomycin. This approach could greatly improve the quality of life and avoid the risks associated with surgery in patients with AIDS who have this problem.