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aerosolized pentamidine as primary prophylaxis for pneumocystis carinii pneumonia: efficacy, mortality and morbidity.primary prophylaxis against pneumocystis carinii pneumonia (pcp) for patients with hiv infection has been recommended by the centers for disease control and prevention. we evaluated alternatives to routine primary pcp prophylaxis with aerosolized pentamidine.19947946102
survival and medical intervention in southern brazilian aids patients.the aim of the study was to describe survival patterns of southern brazilian aids patients: 224 predominantly working class aids patients were treated in an aids referral centre in porto alegre between october 1986 and september 1991. the caseload increased progressively, as did the number of female aids cases treated at the hospital during the study period. self-referred patients were more likely to present with an aids defining condition (p < 0.03) and they (n = 106) had significantly worse su ...19947948159
increased survival of young infants with pneumocystis carinii pneumonia and acute respiratory failure with early steroid administration. 19947948541
pyrimethamine/sulfadoxine for prevention of pneumocystis carinii pneumonia in patients infected with the human immunodeficiency virus. 19947948546
delayed-type hypersensitivity anergy in human immunodeficiency virus-infected persons screened for infection with mycobacterium tuberculosis.a total of 479 human immunodeficiency virus (hiv)-infected persons at an hiv clinic in florida and a tuberculosis clinic in new jersey were skin-tested with tuberculin, tetanus toxoid, mumps antigen, and candida antigen in a study of the prevalence of delayed-type hypersensitivity (dth) anergy and the usefulness of two-step tuberculin testing in this population. of the patients tested, 12% had a positive (> or = 5-mm) response to tuberculin; 57%, 45%, and 35% had a positive (> or = 3-mm) respons ...19947948554
phylogenetic spectrum of fungi that are pathogenic to humans.recent phylogenetic studies based on ribosomal rna sequences have confirmed that the organisms traditionally treated as fungi include those that have evolved from several different lines (multiphyletic organisms), as has been suspected. even organisms causing disease in humans represent at least two evolutional lines. pythium insidiosum and prototheca species are both believed to have evolved from one line, while the rest of the pathogens have evolved from another line. p. insidiosum is more clo ...19947948565
the value of direct fluorescent antibody (dfa) testing for the detection of pneumocystis carinii in cytological specimens.a direct fluorescent antibody (dfa) method was compared with methenamine silver staining (mss) for the detection of pneumocystis carinii in 384 cytological specimens. dfa testing was more sensitive than the mss, with p. carinii detected in 31 specimens with dfa and 24 with the mss. results of the two methods disagreed in 17 specimens, all of which were sputa. twelve sputum specimens were dfa positive/mss negative and five were mss positive/dfa negative. it is concluded that the dfa technique, al ...19947948760
can snomed international represent patients' perceptions of health-related problems for the computer-based patient record?as the united states moves towards a computer-based patient record, there is much discussion related to the contents of such a record and the manner in which the data elements will be represented. recent health care reform has emphasized the need for increased patient involvement in health care decision making, however, there has been little discussion about including the patient perspective in the computer-based patient record. using an existing data set of 201 patients who were hospitalized fo ...19947949916
the hydroxymethyldihydropterin pyrophosphokinase domain of the multifunctional folic acid synthesis fas protein of pneumocystis carinii expressed as an independent enzyme in escherichia coli: refolding and characterization of the recombinant enzyme.the folic acid synthesis (fas) protein of pneumocystis carinii is a multifunctional enzyme containing dihydroneopterin aldolase, 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase (pppk), and dihydropteroate synthase activities. isolation of the stretch of fas cdna shown by amino acid similarity to the bacterial counterparts to code for pppk activity (fasc domain) is described. fasc was expressed to high levels in escherichia coli inclusion bodies using an inducible tac promoter expression syst ...19947950384
changing use of intensive care for hiv-infected patients with pneumocystis carinii pneumonia.clinicians' approach to acute respiratory failure from pneumocystis carinii pneumonia (pcp) is hypothesized to have gone through three phases: aggressive management due to an absence of data on prognosis (1981-84), withholding of intensive care based on a few small studies showing high case fatality (1985-87), and an increase in intensive care to an intermediate level (1988 forward). unfortunately, studies of survival from acute respiratory failure among such patients have been small and have be ...19947952557
persistence of pneumocystis carinii in patients with aids receiving chemoprophylaxis.pneumocystis carinii organisms have been shown to persist throughout therapy in the majority of patients with pneumocystis carinii pneumonia (pcp). this study evaluated the relationship between persistence of organisms and recurrence of disease, and the effect of chemoprophylaxis on bronchoalveolar lavage specimens. seven patients receiving pcp chemoprophylaxis underwent serial bronchoalveolar lavage (bal) examinations at 1, 4, and 7 mo after recovery from a first episode of pcp. specimens were ...19947952576
drug smoking, pneumocystis carinii pneumonia, and immunosuppression increase risk of bacterial pneumonia in human immunodeficiency virus-seropositive injection drug users.to examine the risk factors for the first episode of bacterial pneumonia among human immunodeficiency virus (hiv)-seropositive injection drug users (idus), medical record review was performed on idus participating in a cohort study from january 1988 to june 30, 1992. hiv-seropositive idus with a first episode of bacterial pneumonia (n = 40) were matched with up to five hiv-seropositive control subjects without bacterial pneumonia (n = 197) by date of entry (+/- 3 mo) and length of follow-up. odd ...19947952605
a rapid preadmission method for predicting inpatient course of disease for patients with hiv-related pneumocystis carinii pneumonia.pneumocystis carinii pneumonia (pcp) has been the most common reason for hospitalization and the most common cause of death for persons with hiv infection. hospital mortality rates for pcp range from 10 to 60%. studies that evaluate differences in hospital mortality rates must control for differences in patient severity of illness. we developed a simple staging system for categorizing severity of illness in patients with pcp. we analyzed the relation between clinical factors and in-hospital mort ...19947952607
relation of cyst counts with numbers of total nuclei of pneumocystis carinii in rats.wistar rats were induced of pneumocystis carinii infection by injection with methyl-prednisolone to correlate the cyst counts and numbers of nuclei. seven sections of the lungs were examined by impression smears and also whole lung homogenates were screened for nucleus counting for each rat. at the first week of the experiment, all of the impression smears except one were cyst negative but trophic forms were counted around 10(6). at the third week, the cysts appeared one per 20 immersion oil len ...19947953242
[laboratory and clinical study on pneumocystis carinii. ii. immunoblot analysis for detection of anti-pneumocystis carinii antibodies in the sera from healthy blood donors].rat pneumocystis carinii cyst soluble antigen (csa) was analysed by sds-page, and more than 20 polypeptide bands were found. the molecular weights of the major bands were > 100kda, 85-94kda, 67kda, 52kda and 34kda, respectively. the specific igg antibodies in the sera from healthy blood donors recognizing the 110kda, 105kda, 85kda, 67kda, 52kda and 46kda polypeptide antigens were identified by immunoblot analysis. the total positive rate of igg specific antibodies was 56.7% (59/104). the 85kda p ...19947955159
infections and immunizations in organ transplant recipients: a preventive approach.infections after organ transplantation can be devastating in immunocompromised patients.19947955311
pneumocystis carinii-induced activation of the respiratory burst in human monocytes and macrophages.human monocytes and monocyte-derived macrophages were studied for their ability to phagocytose pneumocystis carinii and produce superoxide (o2-) during the process. one x 10(6) freshly isolated monocytes, incubated with 0.1-3.75 x 10(6) p. carinii cysts, increased o2- production in a dose-related way. antibodies were essential for the process since opsonized, but not unopsonized, pneumocysts induced o2- production significantly above the response obtained by lung tissue from rats (10.7 and 4.9 v ...19947955522
respiratory failure from severe pneumocystis carinii pneumonia. entering the third era. 19947956373
decreasing frequency but worsening mortality of acute respiratory failure secondary to aids-related pneumocystis carinii pneumonia.to describe changes in incidence and outcome of acute respiratory failure (arf) due to aids-related pneumocystis carinii pneumonia (pcp) at a tertiary care center over the 4-year period starting april 1, 1987 with reference to previously reported data from the preceding 6 years.19947956401
estimation of fetal risk from aerosolized pentamidine in pregnant healthcare workers.inhaled pentamidine is used to treat pneumocystis carinii pneumonia. its potential effects on dna have raised concerns about its safety for pregnant healthcare workers. we used a pharmacokinetic approach to estimate the fetal risks, based on the published data of pentamidine renal clearance and of urinary pentamidine concentrations in healthcare workers exposed to aerosolized pentamidine. the maximum pentamidine doses (intravenous equivalent) that healthcare workers were exposed to were calculat ...19947956402
thoracoscopic findings in spontaneous pneumothorax in aids.six patients with the acquired immunodeficiency syndrome (aids) who suffered eight spontaneous pneumothoraces between january 1990 and january 1993 underwent videothoracoscopy. the predominant macroscopic findings, found in four patients on five occasions, were white-yellow nodules dispersed throughout the lung surface. in addition, in one patient, these lesions were associated with multiple small apical bullae and, in another, a large reddish nodule with several smaller white satellite nodules ...19947956424
[minimally invasive surgery in persistent pneumothorax and pneumocystis carinii infection].the most frequent pulmological complication of aids is pneumocystis carinii pneumonia (pcp), which in 2% of cases will cause a spontaneous pneumothorax. every aids patient who develops a pneumothorax is highly suspicious for a pneumocystis carinii pneumonia too. we describe the case of an aids patient who suffered from pneumothorax caused by pcp. conventional tube thoracostomy with continuous suction and tetracycline pleurodesis were unsuccessful. the patient recovered however after resection of ...19947956543
successful treatment of toxoplasma gondii myocarditis in an aids patient.central nervous system disease due to toxoplasma gondii is a common cause of morbidity and mortality in patients with the acquired immunodeficiency syndrome. cardiac toxoplasmosis, however, has been described in only a limited number of cases. in a 45-year-old patient with symptoms suggestive of myocarditis, toxoplasma gondii was detected in myocardial tissue obtained by biopsy. after the institution of appropriate antiprotozoal therapy, the patient recovered. this patient is believed to be the ...19947957272
[intravenous immunoglobulin substitution in patients with arc and aids (wr 3-6)].hiv-infected patients acquire a profound dysfunction in humoral and cellular immunity. this immunological impairment causes a markedly increased incidence of recurrent infections. while effective prophylaxis of pneumocystis carinii pneumonia is available, infections with other microorganisms still cause a high rate of morbidity and mortality. preliminary results of our randomized outpatient trial to evaluate the efficacy of intravenous immunoglobulin (ivig) in adults demonstrate that ivig reduce ...19947959860
pneumocystis carinii attachment increases expression of fibronectin-binding integrins on cultured lung cells.pneumocystis carinii is an extracellular pathogen which requires attachment to alveolar epithelial cells for growth and replication. previous studies have demonstrated that the extracellular matrix protein fibronectin (fn) facilitates attachment of p. carinii to lung cells. this study addresses the role of cell surface fn receptors (integrins) as mediators of p. carinii attachment and demonstrates the effect of p. carinii attachment on integrin expression on cultured lung cells. to determine the ...19947960127
incidence of clinical aids conditions in a cohort of homosexual men with cd4+ cell counts < 100/mm3. multicenter aids cohort study.incidence rates of aids illnesses are described among patients with < or = 100 cd4 cells/mm3 grouped by use of antiretrovirals and chemoprophylaxis. data were obtained from 2646 homosexual men infected with human immunodeficiency virus type 1. participants were in the multicenter aids cohort study during 1985-1993. the incidence rates per 100 person-years for pneumocystis carinii pneumonia were 47.4 without treatment, 21.5 with antiretrovirals alone, and 12.8 with antiretrovirals combined with c ...19947963728
[infections likely to develop in immunocompromised hosts: pneumocystis carinii pneumonia]. 19947964074
pneumocystis carinii pneumonia in infants born to anti hiv positive mothers.infants generally acquire hiv form mother during gestation, or delivery by contact with maternal blood and body fluids or breast feeding. at saraburi hospital, from january 1989 to december 1992, there were 17,766 mothers who gave birth, 80 anti hiv positive mothers were included. up to now, four cases of pcp have been reported in hiv infants born to anti hiv positive mothers at this hospital. all cases presented with symptoms of pneumonia and bilateral bronchopneumonia by chest x-ray. diagnosis ...19937964241
thrush and fever as measures of immunocompetence in hiv-1-infected men.the occurrence of pneumocystis carinii pneumonia (pcp) in human immunodeficiency virus type 1 (hiv-1)-infected individuals with high cd4+ counts indicates poor immunologic function. thrush and persistent fever, easily recognized clinically, are potential measures of immunocompetence. this analysis establishes the complex interactions of cd4+ count, thrush, and persistent fever to predict the occurrence of pcp. analyses used 20,632 person visits from 2,568 hiv-1-seropositive homosexual or bisexua ...19947965635
health care delivery, zidovudine use, and survival of women and men with aids.the aim of this study was to define predictors of survival for women and men after aids diagnosis. we examined health care delivery and drug therapy in the year before aids diagnosis for continuously enrolled new york state medicaid beneficiaries with aids in 1988-1990. we examined the association of these factors with survival after aids diagnosis. of 1,077 women and 1,871 men, 60% of both gender groups were drug users. in both risk groups, women had more outpatient visits than men but were equ ...19947965636
infections in bone marrow transplant recipients in south india--a post-mortem study.a study of post-mortem material obtained from ten patients who had undergone bone marrow transplantation is presented. the cause of death in all patients was infection. six patients had fungal infection, two had bacterial infection and three had cytomegalovirus infection. pneumocystis carinii and tuberculous infections were not detected.19947966537
clinicopathologic correlations of hiv-1-associated vacuolar myelopathy: an autopsy-based case-control study.to determine the clinical correlates of hiv-1-associated vacuolar myelopathy (vm), we designed a case-control study based on 215 aids autopsies in which we examined the spinal cord. we defined a case as an individual dying with aids and with vm present at autopsy; we defined a control as an individual dying with aids without vm. vm was found in 100 of 215 (46.5%) autopsies, with no apparent temporal trends. a higher number of aids-defining illnesses was strongly associated with the likelihood of ...19947969977
improved outcome for young children with aids, pneumocystis carinii pneumonia, and acute respiratory failure.to describe the clinical course of children with acquired immunodeficiency syndrome, requiring mechanical ventilation secondary to pneumocystis carinii pneumonia, with respect to intensive care unit outcome, long-term survival after intensive care unit discharge, and possible predictors of outcome.19947970917
pulmonary pathology in aids: atypical pneumocystis carinii infection and lymphoid interstitial pneumonia. 19947974327
[pulmonary infection with pneumocystis carinii in patients with malignant hematologic diseases].the authors describe their experience with the diagnosis of pulmonary infection with pneumocystis carinii in patients with malignant diseases. in the course of three years they recorded a total of 16 such cases. all cases were diagnosed by bronchoalveolar lavage. the authors analyze in detail the clinical symptoms and radiological picture. attention is drawn to the fact that no finding is specific for the disease. the infection of pneumocystis carinii was combined in 13 cases with another infect ...19947975363
[pulmonary infection with pneumocystis carinii].the author present extensive review on pulmonary infection with pneumocystis carinii. he deals with the following aspects: history, pathophysiology, clinical picture and diagnosis. diagnostic methods used at present are described in great detail. therapy and prevention are not discussed.19947975365
fulminant reexpansion pulmonary edema in a patient with aids.a 23-year-old man with aids presented to the emergency department with recurrent spontaneous pneumothoraces secondary to recent pneumocystis carinii pneumonia. shortly after placement of bilateral pigtail catheters for chest reexpansion, he developed fatal unilateral reexpansion pulmonary edema. the association between p carinii pneumonia and pneumothorax, and the risk factors and pathophysiology of reexpansion pulmonary edema are reviewed. emergency physicians should recognize that reexpansion ...19947978577
adverse cutaneous reactions to trimethoprim-sulfamethoxazole in patients with the acquired immunodeficiency syndrome and pneumocystis carinii pneumonia.patients with the acquired immunodeficiency syndrome are predisposed to cutaneous drug reactions. the reasons are poorly understood and the circumstances in which such patients can be treated through hypersensitivity are a matter of discussion. we assessed the value of clinical and laboratory parameters for predicting trimethoprim-sulfamethoxazole-induced skin reactions and the effects of continued trimethoprim-sulfamethoxazole therapy in such patients. we retrospectively studied all episodes of ...19947979438
detection of pneumocystis dna in nasopharyngeal aspirates of leukaemic infants with pneumonia.the technique of polymerase chain reaction was used to detect pneumocystis carinii dna in nasopharyngeal secretions of three infants with leukaemia who had the clinical features of p carinii pneumonia. the use of this non-invasive technique allowed the early diagnosis and treatment of these infants whose protocols did not include the use of prophylactic co-trimoxazole.19947979502
management of adverse reactions to trimethoprim-sulfamethoxazole in human immunodeficiency virus-infected patients.trimethoprim-sulfamethoxazole is an important medication for the treatment and prevention of pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. use of this medication has been limited by the high frequency of adverse reactions that occur in patients with human immunodeficiency virus disease. this article reviews the incidence and spectrum of adverse reactions and options for continuing therapy with trimethoprim-sulfamethoxazole in human immunodeficiency virus ...19947979835
the continuing utility of bronchoalveolar lavage to diagnose opportunistic infection in aids patients.to determine whether bronchoalveolar lavage (bal) remains a useful technique in assessing human immunodeficiency virus (hiv)-infected patients with pulmonary symptoms.19947985710
albendazole inhibits pneumocystis carinii proliferation in inoculated immunosuppressed mice.albendazole, a benzimidazole derivative widely used for treating helminth infections, was successfully used to treat and prevent development of pneumocystis carinii pneumonia in transtracheally inoculated immunosuppressed mice. for treatment, 3 weeks postinoculation, albendazole at 300 and 600 mg/kg of body weight per day was administered in food for 3 weeks. for prophylaxis, albendazole was begun on the same day as inoculation at 300 mg/kg/day for 7 days, and then the dose was reduced to 150 mg ...19947986016
pneumocystis carinii is resistant to imidazole antifungal agents.because pneumocystis carinii is closely related to fungi, drugs useful for treating mycoses have been considered for use in the treatment of p. carinii pneumonia. six antifungal imidazole drugs were tested for their activities against p. carinii in a short-term culture screen and in animals. none of the imidazoles tested was effective in inoculated infected rats, and only miconazole showed slight effects in culture at the high concentration of 10 micrograms/ml. analysis of cell membranes from cu ...19947986021
[cytomegalovirus pneumopathies in pediatric intensive care units].cytomegalovirus (cmv) infection can result in major complications in immunocompromised infants and children. cmv pneumonia may be difficult to diagnose and the true pathogenic role of the virus in the disease is not always clear. this report describes a cohort of 20 children who suffered from cmv pneumonia.19947987439
comparison of ballard catheter bronchoalveolar lavage with bronchoscopic bronchoalveolar lavage.bronchoscopic bronchoalveolar lavage (bal) in mechanically ventilated patients requires a large endotracheal tube, physician expertise, expensive equipment, and support staff.19947988195
geographical pathology profile of aids in puerto rico: the first decade.postmortem histopathological changes in 100 adult patients with aids who died in puerto rico from 1982 to 1991 were studied and tabulated. modes of hiv transmission were reviewed. patient ages ranged from 21 to 60 yr. gender composition for the patient group was 83 men (average age, 35 yr) and 17 women (average age, 39 yr). sixty-eight of the patients were injecting-drug users, 20 were homosexual and bisexual men, seven were women who had had heterosexual contact with men at risk for hiv, and on ...19947991523
prophylaxis of toxoplasmosis infection with pyrimethamine/sulfadoxine (fansidar) in bone marrow transplant recipients.prophylaxis against toxoplasmosis with weekly administration of pyrimethamine/sulfadoxine (fansidar) was assessed for efficacy and toxicity in bone marrow transplant (bmt) recipients over a 21 month period. sixty-nine of 90 consecutive seropositive patients were evaluable. fansidar was administered from the time of established engraftment (median day 40, range days 13-100). medication was scheduled to be continued until 6 months or longer in cases of continued immunosuppression (median 10 months ...19947994239
[current alternatives in the treatment of pneumocystis carinii pneumonia in patients with aids]. 19947996899
update of the rapid diagnosis of infectious diseases. i: bacteria, fungi and parasites.the application of monoclonal antibodies and dna probes in the clinical microbiology laboratory has resulted in an array of rapid diagnostic tests. the immunofluorescent assay or enzyme-linked immunoassay is widely used in the rapid diagnosis of bacteria eg group a streptococcus, legionella pneumophila, mycoplasma pneumoniae, bordetella pertussis; parasites eg chlamydia tachomatis, cryptosporidium species; and fungi eg pneumocystis carinii. the bactec system was first introduced to detect bacter ...19947997914
bronchogenic carcinoma in hiv-positive patients: findings on chest radiographs and ct scans.the radiographic manifestations of bronchogenic carcinoma in hiv-positive individuals may resemble or accompany changes of inflammatory disease. to provide information that is useful in the differential diagnosis, we studied the findings on plain radiographs and chest ct scans in 30 hiv-positive patients with proven bronchogenic carcinoma and correlated the radiographic features with the presence or absence of thoracic opportunistic infection.19957998569
changes in insurance status and access to care for persons with aids in the boston health study.the purpose of this study was to measure unmet needs and changes in insurance status for persons with acquired immunodeficiency syndrome (aids). thirty-six percent of the study's boston-area respondents (n = 305) had a change in insurance coverage between aids diagnosis and interview. medicaid coverage increased from 14% to 41%. pneumocystis carinii pneumonia prophylaxis was nearly universal. only 5% did not receive zidovudine, and intravenous drug users were at higher risk. approximately 14% to ...19947998646
a survey of birds in denmark for the presence of pneumocystis carinii.one hundred eighty-three toluidine blue o-stained necropsy lung imprint smears from different avian species were examined microscopically for pneumocystis carinii. no cyst forms of the organism could be identified. seventy-eight serum samples from a total of 155 chickens were examined by a competition enzyme-linked immunosorbent assay (elisa) for antibodies to p. carinii; 53 serum samples were from individual chickens, and 25 samples were pools of sera from two to five chickens. diluted 1:50, th ...19948002876
pulmonary disease associated with the human immunodeficiency virus in kigali, rwanda. a fiberoptic bronchoscopic study of 111 cases of undetermined etiology.all human immunodeficiency virus type 1 (hiv-1) infected adult patients referred to the division of pulmonary diseases of the centre hospitalier de kigali, rwanda for evaluation of a pulmonary disease of undetermined etiology (pdue) were investigated by fiberoptic bronchoscopy using both bronchoalveolar lavage (bal) and transbronchial biopsy (tbb). during a 10-mo period 111 hiv-1 infected patients with pdue were examined, of whom 47 (42%) fulfilled the world health organization (who) clinical ca ...19948004318
diffuse thallium lung uptake in pneumocystis carinii pneumonia.five patients with aids with pneumocystis carinii pneumonia (pcp) showed diffuse bilateral lung uptake on sequential thallium and gallium scans. this creates a problem in the sequential use of these tests for the differentiation of kaposi's sarcoma from acute inflammatory or other malignant diseases. in kaposi's sarcoma, thallium uptake is usually focal and not diffuse unless associated with other pathology. however, in pcp the diffuse thallium lung uptake may be due to congestion, increased vas ...19948004857
local antibodies against pneumocystis carinii in bronchoalveolar lavage fluid.pneumocystis carinii pneumonia (pcp) is a frequent cause of pneumonia among human immunodeficiency virus (hiv)-infected patients. little is known, however, about the role played by humoral immunity to control the infection. this study was undertaken to elucidate the role played by local antibodies. bronchoalveolar lavage (bal) fluids from 18 acquired immune deficiency syndrome (aids) patients with pcp, 20 hiv-antibody positive patients without pcp, and 20 lung cancer patients were examined for a ...19948005248
[scintigraphy with gallium-67 citrate in patients with aids: pathologic extrapulmonary uptake].67gallium citrate can accumulate in different inflammatory and neoplastic lesions. the mechanisms of 67gallium uptake in abnormal tissue are still partially unknown and the tracer is considered a nonspecific indicator of disease. in aids patients, 67gallium citrate is used in the diagnosis and characterization of opportunistic pulmonary infections and especially of pneumocystis carinii pneumonia. from june 1989 through december 1992 in our department 140 67gallium scans were performed on 103 aid ...19948008901
[pneumococcal endocarditis and pneumocystis carinii pneumonia in a patient with hiv infection]. 19948008937
impairment of exercise capacity in various groups of hiv-infected patients.it is known that pulmonary function is impaired during the course of hiv infection even in early stages. in order to estimate the resulting reduction of exercise capacity, different groups of hiv patients were investigated. group 1 consisted of 20 patients without a history of respiratory disease and without actual lung disease, group 2 of 18 patients with a former episode of pneumocystis carinii pneumonia (pcp) without actual lung disease, and group iii of 37 patients with different broncho-pul ...19948008992
[is the risk of pneumocystosis predictable in wegener's disease?].twelve cases of pneumocystis pneumonia in patients with wegener's granulomatosis were compared with a control-group of 32 patients. our study showed that the dose of cyclophosphamide received in the first three months and a profound lymphocytopenia were strongly predictive of a risk of pneumocystis carinii pneumonia in these patients.19938009021
clinical experience with atovaquone: a new drug for treating pneumocystis carinii pneumonia.atovaquone is a new hydroxynapthoquinone antiprotozoal agent active against pneumocystis carinii in vitro and in animal models. the authors report an experience using atovaquone to treat 25 patients with mild to moderate p. carinii pneumonia. eligible patients were treated for 21 days with 750 mg of atovaquone orally three times daily. prednisone was added when the p(a-a)o2 gradient was between 35-45 mm hg. patients were treated under three treatment protocols. patients in group 1 participated i ...19948010339
rapid and sensitive diagnosis of cytomegalovirus and pneumocystis carinii pneumonia in patients with haematological neoplasia by using capillary polymerase chain reaction.we attempted the simultaneous detection of cytomegalovirus dna (cmv-dna) and pneumocystis carinii (carinii-dna) in sputum samples obtained from 20 patients with haematological neoplasm with pneumonia, using rapid cycle dna amplification (capillary pcr). we used a thermal cycler for capillary pcr which featured recirculation of hot air for rapid temperature control of 10 microliters reaction samples in thin glass capillary tubes. we extracted dna from patients' sputa using a simple method. a comp ...19948011522
[clindamycin-primaquine in the treatment of pneumocystis carinii pneumonia].the efficacy of clindamycin-primaquine as treatment of pneumocystis carinii pneumonia (pcp) is similar to that of trimethoprim-sulfamethoxazol and endovenous pentamidine. the untoward effects of this combination are scarce and of mild degree.19948011723
effect of corticosteroids on the incidence of adverse cutaneous reactions to trimethoprim-sulfamethoxazole during treatment of aids-associated pneumocystis carinii pneumonia.we retrospectively studied all courses of treatment with trimethoprim-sulfamethoxazole (tmp-smz) alone and with adjuvant corticosteroids for aids-associated pneumocystis carinii pneumonia. the corticosteroids were administered for 8-21 days (mean, 14 days) because of hypoxemia. we evaluated the influence of corticosteroids on the incidence of cutaneous adverse reactions to tmp-smz and on the course of aids during 3 months of follow-up. of 38 patients treated with tmp-smz alone, 18 (47%) develope ...19948011811
detection of pneumocystis carinii in urinary samples from a patient with aids despite prophylactic treatment with aerosolized pentamidine. 19948011843
imaging of hiv infection in the prenatal and postnatal period.prenatal diagnosis of maternal diseases common to hiv infection may alert the clinician to potential hiv infection in the infant, with resultant early diagnosis and treatment. although of limited value in the first months of life, imaging studies can be beneficial in selected cases and may be the first clue to the diagnosis of aids. the multisystem involvement frequently seen in aids necessitates multiple imaging modalities. recurrent pneumonia, particularly pneumocystis carinii pneumonia, may b ...19948013181
effect of sputum induction on arterial oxygen saturation and spirometry in hiv-infected patients.we wanted to study the effect of sputum induction on forced expiratory volume in one second (fev1) and on oxygen saturation in normal controls, asymptomatic human immunodeficiency virus (hiv)-seropositive individuals, and hiv-seropositive patients under investigation for suspected pneumocystis carinii pneumonia (pcp). over a five month period, sputum induction with ultrasonically nebulized 3% saline was performed on 110 hiv-seropositive patients with suspected pcp, 10 asymptomatic hiv-seropositi ...19948013601
trimetrexate with leucovorin versus trimethoprim-sulfamethoxazole for moderate to severe episodes of pneumocystis carinii pneumonia in patients with aids: a prospective, controlled multicenter investigation of the aids clinical trials group protocol 029/031.trimetrexate is a powerful inhibitor of the dihydrofolate reductase of pneumocystis carinii. aids patients (n = 215) with moderate to severe p. carinii pneumonia were enrolled in a double-blind study of trimetrexate plus leucovorin versus trimethoprim-sulfamethoxazole (tmp-smz) for 21 days. by study day 10, study therapy failed because of lack of efficacy in 16% of patients assigned to tmp-smz and 27% assigned to trimetrexate (p = .064), and the pao2-pao2 improved significantly faster with tmp-s ...19948014493
temporal trends of opportunistic infections and malignancies in homosexual men with aids.temporal changes in the lifetime occurrence of opportunistic infections and malignancies among 1115 homosexual men diagnosed with aids were examined. information from the aids surveillance registry, hospital pathology and microbiology logs, patient chart reviews, cancer registries, and death certificates was used to calculate the frequency of specific opportunistic infections and malignancies as lifetime (initial or subsequent) diagnoses. the most common lifetime diagnoses were pneumocystis cari ...19948014498
invasive diagnostic approaches to pulmonary infiltrates.the clinical and radiographic presentation of pulmonary disease in organ-transplant recipients often fails to allow the specific identification of a causative pathogen or permit the distinction between infectious and noninfectious processes. frequently, invasive procedures are required to make a specific diagnosis and initiate appropriate therapy. the early use of transtracheal aspiration proved useful for the diagnosis of bacterial and mycobacterial pneumonias. however, its inability to reliabl ...19938016476
diagnosis of pulmonary infections in patients with organ transplants using noninvasive diagnostic laboratory tests.lower respiratory-tract infection in patients with transplants or other forms of immune compromise is a serious disease with high mortality. rapid, accurate diagnostic tests are essential for these patients. the required tests include those for pneumocystis carinii, mycobacteria, fungi, legionella, viruses, and bacteria. using currently available technology, a combination of new and conventional tests for these various pathogens can provide comprehensive information within the first 24 hours of ...19938016477
cardiac transplantation and related infections.infection is a serious cause of morbidity and mortality in the cardiac transplant patient. early infections within the first month after transplantation are usually caused by nosocomial pathogens, such as pseudomonas aeruginosa, staphylococcus aureus, enterococci, and members of enterobacteriaceae and include pneumonia, urinary-tract and would infections, and bacteremia associated with the use of intravascular devices. late infections, usually occurring after the first month and within the first ...19938016480
randomized trial of dapsone and aerosolized pentamidine for the prophylaxis of pneumocystis carinii pneumonia and toxoplasmic encephalitis.pneumocystis carinii pneumonia (pcp) and toxoplasmic encephalitis are the most frequent pulmonary and central nervous system opportunistic infections associated with human immunodeficiency virus (hiv) infection. we designed a prospective study to compare the effects of aerosolized pentamidine and dapsone in the prophylaxis of these infections in hiv-infected persons with cd4+ lymphocyte counts less than 250/mm3.19938018144
early onset of pneumocystis carinii pneumonia in a patient receiving bone marrow transplantation from a matched unrelated donor. 19948019447
the relationship between type of care planning system and patient outcomes in hospitalized aids patients.the purpose of this study was to describe the problems of hiv-infected patients, hospitalized for pneumocystis carinii pneumonia (pcp), as documented in the nursing care plan and to examine differences in the number and type of activated patient problems and patient outcomes between manually generated, computer-supported, and standardized care planning systems. of the sample, 22% had no care plan. in the computer-supported care planning system the fewest number of care plans were completed. the ...19948021390
cystic pulmonary lesions in pneumocystis carinii infection.thick-walled pulmonary cavities are an uncommon manifestation of pneumocystis carinii pneumonia (pcp). a case of pcp in a man with acquired immunodeficiency syndrome (aids) presenting with a thick-walled pulmonary cavity and multiple smaller pulmonary air cysts is described. all of these lesions showed dramatic healing with therapy. a brief review of the recent literature is also presented.19948024510
opportunistic infection during treatment with low dose methotrexate.two patients receiving low dose methotrexate, one with rheumatoid arthritis and the other with pityriasis rubra pilaris, developed disseminated histoplasmosis and mycobacterium avium intracellulare pneumonia, respectively. twenty-three cases of opportunistic infection in patients receiving low dose methotrexate have been reported previously, with pneumocystis carinii pneumonia being the most common infection (10 of 23, 43%). patients receiving low dose methotrexate are at risk for opportunistic ...19948025760
[neutrophilia in the bronchoalveolar lavage of patients with aids and pneumocystis carinii pneumonia. reflections on its prognostic value in the spanish setting].the prognostic value of neutrophilia (> 5%) in bronchoalveolar lavage (bal) in our context is studied in 21 patients with aids and pneumocystis carinii pneumonia. neutrophilia does not seem to be a good prognostic indicator in our context. we have found this condition, with a mean of 6 +/- 4%, in only 33% of our sample. the sensitivity of this parameter with respect to risk of death was very low (25%), while specificity was moderate (65%). in contrast with what has been reported in studies done ...19948025785
cd4+ lymphocytopenia due to common variable immunodeficiency mimicking aids.there are an increasing number of published reports of patients with acquired immunodeficiency without evidence of hiv infection, who have been labelled as having "idiopathic cd4+ lymphocytopenia". the case is reported here of a young man who presented with pneumocystis carinii pneumonia (pcp), cd4+ lymphopenia, and hypogammaglobulinaemia attributable to common variable immunodeficiency (cvid). the presentation of this condition, with many of the clinical and laboratory features of aids, highlig ...19948027379
cytomegalovirus pneumonitis: spectrum of parenchymal ct findings with pathologic correlation in 21 aids patients.to identify characteristic features of cytomegalovirus (cmv) pneumonitis at computed tomography (ct), particularly markers that may help differentiate cmv from pneumocystis carinii pneumonia.19948029414
what is the role of t-lymphocytes with gamma/delta receptors in pneumocystis carinii pneumonia in aids patients? 19948031525
administration of aerosol pentamidine: a program design.aerosol pentamidine (ap) is an fda-approved prophylaxis against pneumocystis carinii pneumonia (pcp) in hiv-infected individuals who have a cd4+ lymphocyte count less than 200/mm3, constitutional symptoms, or a previous history of the pneumonia. the university of washington medical center, a 450-bed tertiary care center, established a successful aerosol pentamidine treatment program, providing treatment in its special procedure nit. the authors present an overview of ap and discuss the role of i ...19948032012
invasive pulmonary aspergillosis associated with low dose methotrexate therapy for rheumatoid arthritis: a case report of treatment with itraconazole.opportunistic infections complicating low dose methotrexate therapy are rare, consisting predominantly of pneumocystis carinii pneumonia. we report a case of invasive pulmonary aspergillosis which developed in a patient being treated for seropositive rheumatoid arthritis with low dose methotrexate (5-7.5 mg weekly) for 8 years. the patient was successfully treated with itraconazole 200 mg daily for 6 months. this case adds to the growing evidence implicating low dose methotrexate with opportunis ...19948032050
[thoracoscopic treatment of recurrent pneumothorax].spontaneous pneumothorax (pno) is usually due to rupture of a small subpleural bleb into the pleural cavity and affects mainly young men. after simple drainage, recurrence occurs in about 50% of cases. the risk of recurrence increases after each new pno. secondary pno complicates an underlying pulmonary disease, especially chronic obstructive pulmonary disease with emphysema. a new form of secondary pno has emerged in the recent years in aids patients with pneumocystis carinii pneumonia. we have ...19948034519
close association of pneumocystis carinii from infected rat lung with culture cells as shown by light and electron microscopy.studies of the association of rat-origin pneumocystis carinii with culture cells were performed both to learn more about the role of cells in p. carinii culture and to evaluate additional cell lines in an effort to improve culture methods. proliferation of trophozoites of p. carinii from rat lung in cultures with six lung cell lines was demonstrated by light microscopic evaluations of both giemsa-stained and immune-specific-stained culture samples. scanning electron microscopy and transmission e ...19948036234
a highly unusual combination of pulmonary pathogens in an hiv infected patient.we report on a case with an unusual combination of pulmonary pathogens including pneumocystis carinii, rhodococcus equi and toxoplasma gondii in an hiv infected patient. the multiple microbiological procedures required to ascertain the etiological diagnoses of pneumonitis in hiv-seropositive subjects are discussed.19948036478
spontaneous pneumocystis carinii infection in the dog with naturally acquired generalised demodicosis. 19948036776
adverse reactions to dapsone in persons infected with human immunodeficiency virus.dapsone is used in prophylaxis for and treatment of pneumocystis carinii pneumonia. we present a case of stevens-johnson syndrome that was likely induced by administration of dapsone. a review of charts at the hiv treatment center of northwestern university (chicago) revealed that 40.3% of patients treated with trimethoprim-sulfamethoxazole could not tolerate the medication, while 25.2% of those treated with dapsone were intolerant of the drug. we also found a higher rate of adverse reactions to ...19948038322
pneumocystis carinii pneumonia: relationship between cyst size and response to treatment.pneumocystis carinii pneumonia is a common cause of death in patients with aids. diagnosis is based on cytological examination of smears prepared from induced sputum samples and bronchoalveolar lavage (bal) specimens which have been stained with methenamine silver. we have examined 46 bal/induced sputum specimens from patients who had clinical symptoms and signs suggestive of p. carinii pneumonia and measured the diameter of a minimum 100 cysts in each specimen. we found that cyst size correlate ...19948038427
[spontaneous and iatrogenic pneumothorax in the adult. 217 personal cases].this study is dedicated to the epidemiology of pneumothoraces (217 cases) during the last 8 years in an intensive care department where most patients were admitted for respiratory diseases. cases resulting from road-injury or surgery were excluded. spontaneous pneumothoraces accounted for 61.8% of the cases. among them, the most current etiology was idiopathic pneumothorax owing to small subpleural blebs, rarely leading to tension pneumothorax or hemapneumothorax. other causes were pulmonary emp ...19948039003
gallium-avid painless thyroiditis in a patient with aids.intense thyroidal ga-67 accumulation was seen in a man with aids imaged for suspected pneumocystis carinii pneumonia. concurrent tc-99m pertechnetate thyroid scanning demonstrated absent trapping, helping establish the diagnosis of painless thyroiditis. occult hyperthyroidism, and not pulmonary infection, may have been responsible for the patient's original presenting symptoms.19948039315
cellular responses to a 55-kilodalton recombinant pneumocystis carinii antigen.the host-parasite interaction in pneumocystis carinii pneumonia is poorly understood. in recent years, two major groups of p. carinii antigens have been identified. one class of antigens is characterized by a broad band of immunoreactivity between 45 and 55 kda in p. carinii derived from rats. this antigen complex is the p. carinii antigen most commonly found in respiratory tract specimens and most frequently recognized by the host immune response. the availability of a recombinant antigen has p ...19948039919
the acquired immune deficiency syndrome: an overview for the emergency physician, part 1.the acquired immune deficiency syndrome (aids) was recognized as a distinct entity in 1981. it began as a medical curiosity affecting only several dozen individuals in a restricted segment of the u.s. population. in the 12 years since its description, aids has become a pandemic affecting tens of millions with cases reported from all major countries. the illness is caused by a retrovirus, termed human immunodeficiency virus (hiv). it is a blood-borne disease with sexual, parenteral, and perinatal ...19948040596
[a case of adult t cell leukemia complicated with strongyloidiasis and amplification of pneumocystis carinii dna in bronchoalveolar lavage fluid].the patient was a 75-year-old male, who simultaneously showed symptoms of bacterial meningitis during steroid treatment for erythroderma and symptoms of respiratory failure. based on ground-glass shadows in both lungs on chest x ray, bronchoalveolar lavage (bal) was carried out and strongyloides was detected. in addition to strongyloidiasis, the patient was shown to have the complication of pneumocystis carinii (pc) pneumonia after pc dna was detected in bal fluid using a pcr assay. when other c ...19948041045
[atypical radiological images in pneumocystis carinii infection in hiv-positive patients].to assess the prevalence of atypical pcp patterns in aids patients, the chest films of 300 patients with clinical and laboratory diagnosis of pcp were reviewed. we considered as atypical patterns the finding of an asymmetric lesion, the involvement of apical regions, pleural effusion, hilar and/or mediastinal lymphadenopathy, parenchymal nodules and pneumatoceles. in some patients more than one of these patterns was found. atypical patterns were observed in 32% of cases and consisted of: unilate ...19948041929
cytologic diagnosis of extrapulmonary pneumocystis carinii infection in pleural and ascitic fluid. report of a case in a patient with the acquired immunodeficiency syndrome.we present a case of an extrapulmonary pneumocystis carinii infection in a human immunodeficiency virus-positive patient undergoing prophylactic treatment with pentamidine. the diagnosis was established in pleural and ascitic fluid, and the patient died before starting specific systemic treatment. we discuss the cytologic differences between pulmonary and extrapulmonary infections and the importance of careful screening for this pathogen in immunosuppressed patients.19948042433
four different regimens for prevention of pneumocystis carinii pneumonia and toxoplasma encephalitis in hiv-infected patients. 19948043236
failure of pentamidine as prophylaxis for pneumocystis carinii pneumonia in hiv-infected children. 19948044270
the role of flexible bronchoscopy in children with aids: an update of the new york university experience.the clinical courses of children with acquired immunodeficiency syndrome (aids) who underwent diagnostic flexible bronchoscopy at bellevue hospital from 1987-1992 were reviewed to determine the value of the procedure in patient management. twenty-eight children (age 13 days to 12 years) underwent 31 bronchoscopies for indications including respiratory distress, fever and abnormal chest radiograph. procedures were well tolerated. complications were limited to transient hypoxia and epistaxis. alth ...19948045694
[effects of the 1987 revision of the definition for an aids case in switzerland].aids cases diagnosed in switzerland after the revision of 1987 and reported to the swiss federal office of public health until 31.12.1992 were categorised according to whether they conformed to the diagnostic criteria valid before the revision (= "pre-87"-group) or only to the new criteria introduced with the revision (= "post-87"-group). compared to the "pre-87"-group, the proportion of injecting drug users was higher, the proportion of homosexual men was lower, the patients were younger and pn ...19948048273
genetic diversity of pneumocystis carinii derived from infected rats, mice, ferrets, and cell cultures.the degree of strain and/or species diversity among pneumocystis carinii isolates is unknown. as a first approach to the study of p. carinii genetic relatedness, we compared the pulsed field gel electrophoretic karyotypes of p. carinii derived from lung homogenates of three immunosuppressed host animals: rats transtracheally inoculated with p. carinii-infected mouse lung; and ferrets which developed reactivated latent p. carinii pneumonia. rat p. carinii propagated on hel299 cells was also exami ...19948049685
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