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We present a patient who collapsed with chest pain and dyspnoea on a transatlantic flight. She was found to have Pneumocystis carinii pneumonia (PCP) and human immunodeficiency virus infection. Platypnoea and orthodeoxia, which have not been previously reported in association with PCP, were major features of her illness. The PCP predominantly affected her lung bases and it is likely that gravity increased intrapulmonary blood flow through poorly ventilated lung bases with failure of pulmonary vasoconstriction to increase upper zone perfusion, exacerbating desaturation on sitting up. The partial DNA sequence of the infecting P carinii was identical to previously described isolates.

Original publication

DOI

10.1136/thorax.58.2.185

Type

Journal article

Journal

Thorax

Publication Date

02/2003

Volume

58

Pages

185 - 186

Keywords

Acquired Immunodeficiency Syndrome, Dyspnea, Fatal Outcome, Female, Humans, Hypoxia, Middle Aged, Pleurisy, Pneumonia, Pneumocystis, Posture