Pneumocystis in Infants and Children

To the Editor: Each of two important reports on Pneumocystis carinii in the March 23 issue¹,² lacks convincing proof of diagnosis. The letter by Mortier et al.¹ describes maternal–fetal transmission of P. carinii associated with HIV infection. The case is based on the finding of up to 20 P. carinii cysts in each of five intraalveolar macrophages in the lungs of a dead fetus delivered of a mother in whom P. carinii cysts had been detected within the previous three weeks. Unfortunately, the color photomicrograph used to demonstrate the presence of P. carinii cysts does not show organisms recognizable.