Pneumocystis carinii pneumonia. Diagnosis by examination of pulmonary secretions

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Abstract
To determine if examination of respiratory secretions is useful in diagnosing P. carinii pneumonia, smear preparations of expectorated sputum, tracheal aspirates and transtracheal aspirates stained by the Gomori methenamine silver nitrate method were examined. Pneumocysts were observed more frequently in material obtained by transtracheal aspiration than in secretions obtained by the other methods. Transtracheal aspiration yielded material containing pneumocysts in 8 (13%) of 60 patients; each had pulmonary infiltrates and clinical courses consistent with P. carinii pneumonia. Of 330 smear preparations examined from expectorated sputum, 3 patients had pneumocysts in their sputum and 1 had organisms in transtracheal aspiration and expectorated sputum; all 3 had pneumonia. Transtracheal aspiration is a useful initial step in the approach to the diagnosis of P. carinii pneumonia.

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