Unusual remission of pneumocystis carinii pneumonia in a patient with the acquired immune deficiency syndrome

Pneumocystis carinii is a well-recognized cause of pneumonia in patients with immune deficiency, and when untreated, mortality approaches 100 percent. Although rare cases suggesting spontaneous recovery (usually accompanied by resolving immune deficiency) have been reported, spontaneous resolution of P. carinii pneumonia in patients with the acquired immune deficiency syndrome (AIDS) has not been described. A patient with AIDS in whom Pneumocystis pneumonia developed and remitted without appropriate therapy is described. This case suggests that the immunologic defects of AIDS are not fixed and that fluctuations in the degree of immunocompetence may allow for clinical recovery from opportunistic infections associated with AIDS even without appropriate therapy.