1 Department of Pediatrics, University of Minnesota Hospitals, Minneapolis Children's Hospital and Health Center, and St. Paul Children's Hospital Minneapolis, Minnesota
Two refugee Vietnamese infants developed pneumonia unresponsive to antibiotics. Clinical signs included malnutrition, a history of recent bacterial infection, and the acute development of fever, cough, and increasing respiratory distress with hypoxia. Lungs were clear on auscultation. Diagnosis of P. carinii in both was made by lung biopsy, and the infants recovered after pentamidine isethionate therapy. Laboratory evidence suggesting cell-mediated immune deficiency was present in both patients. Physicians caring for infants with pneumonia unresponsiveness to antibiotics, especially if the neonatal history is unknown, should proceed immediately with diagnostic studies for P. carinii.