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Four adult recipients of cadaveric renal homografts acquired Pneumocystis carinii infections from which they subsequently died. The disease in adults under immunosuppressive therapy runs a course different from the disease observed in newborns. The clinical course is rapidly progressive and early diagnosis by means of aggressive diagnostic procedures is mandatory. To prevent a fatal outcome, treatment even on suspicion is suggested. Epidemiologically, a person-to-person spread seems possible and isolation of the patient is necessary.
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