Pneumocystis carinii is the opportunistic pathogen most frequently causing pneumonitis in the acquired immunodeficiency syndrome (AIDS). The extrapulmonary or disseminated form of this infection is unusual in AIDS and other immunodeficiency states, malignancy, or immunosuppression. We report a rare case of P. carinii hepatitis in a patient with AIDS diagnosed before death. The patient had apical pneumonitis and pneumothoraces while taking aerosolized pentamidine for prophylaxis. A 33-year-old white homosexual man, diagnosed as having AIDS and P. carinii pneumonia in February and August 1987, was hospitalized in May 1988 with a 3-day history of productive cough, left-sided pleuritic chest