[Non-invasive mechanical ventilation as treatment for severe pneumonia in an HIV positive patient].

A 27 year-old HIV+ patient was admitted to the hospital for probable Pneumocystis carinii pneumonia (PCP). He was severely dyspneic, with respiratory rate of 44 x min and accessory respiratory muscle contraction. The alveolar-arterial quotient was 0.35. Ventilation by BiPAP was applied during 12 hours. After BiPAP a/AO2 was O.42, with amelioration of dyspnea, decrease of respiratory rate (25 x min) and without using of accessory respiratory muscles. No complications occurred. At the end of hospital stay a/AO2 was 0.68. CPAP application but not BiPAP has been reported in PCP. Our patient showed evident improvement after BiPAP, suggesting that this method of ventilation is useful and should be incorporated to the routine management of these patients.