Pneumocystis Carinii in the Temporal Bone as a Primary Manifestation of the Acquired Immunodeficiency Syndrome

Extrapulmonary infection with Pneumocystis carinii is rare and is usually associated with severe systemic illness. We report, in two patients, the histologic, ultrastructural, and monoclonal cell surface antibody identification of P carinii in otic polyps. Both patients had serum antibody to human immunodeficiency virus. These P carinii infections in the temporal bone are unusual in their location and in the apparent absence of associated pulmonary infection. This otologic presentation was the primary manifestation of the acquired immunodeficiency syndrome.