Pneumocystis carinii Pneumonia

Publisher Website
Google Scholar
Abstract
P. carinii pneumonia has become a serious and often fatal problem complicating the use of immunosuppressive chemotherapy. The clinical, roentgenographic and pathological features of 7 cases from the National Institutes of Health are presented. Six of the 7 patients had received long term prednisone therapy either alone or in conjunction with cytotoxic agents. Five had malignant diseases of the reticuloendothelial system. The patients presented with a clinical syndrome characterized by dyspnea, usually with cyanosis and a dry hacking cough, but with few physical findings on auscutation of the lungs. Chest roentgenograms always showed diffuse bilateral interstitial infiltrates. The clinical and roentgenographic picture was most often confused with miliary tuberculosis or acute pulmonary edema secondary to cardiac decompensation. Although P. carinii pneumonia was suspected in several of these cases, ante morten confirmation was never accomplished. Because of experimental and clinical reports on the effectiveness of pentamidine isothionate in this disease, 2 patients were treated empirically, but without success. The short duration of therapy in these cases may have been responsible for the lack of response. The effectiveness of pentamidine isethionate in clinical P. carinii pneumonia can be evaluated only by early institution and adequate trial of therapy in patients with an established diagnosis. At present, lung biopsy appears to be the most reliable diagnostic procedure.

This publication has 2 references indexed in Scilit: