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use of a rapid differential stain for identifying pneumocystis carinii in bronchoalveolar lavage fluid. diagnostic efficacy in patients with aids.identification of pneumocystis carinii involves silver stains which require several hours for processing. diff quik, a differential stain similar to wright-giemsa, requires less than 1 min and reproducibly stains trophozoites and intracystic bodies of p carinii. to determine the utility of dq for rapid detection of p carinii in bal fluid, we reviewed dq-stained slides of 50 bal samples from 36 patients seropositive for hiv+ who had undergone bronchoscopy with bal for evaluation of interstitial p ...19892465872
type i reactions directed against pneumocystis carinii in aids patients.type i allergy directed against pneumocystis carinii (pc) has been investigated in 14 patients with aids. the pneumocystis carinii pneumonia often shows a rapid and severe course, and type i allergy against the parasite might be a pathogenic co-factor in the interstitial lung inflammation. in twelve of the aids patients the clinical symptoms and course of illness indicated a pc pneumonia. the basophil histamine release test was used as a sensitive test to detect type i allergy against pc. eight ...19892465772
rapid and simple metachromatic stain for pneumocystis carinii. 19892464854
silver staining of pneumocystis carinii in the rat's lung.the backscattered electron imaging mode of the scanning electron microscope was used to study the ontogenetic acquisition of argyrophilia in pneumocystis carinii in rats. silver staining continually increased from the late trophozoite to the mature cyst stage. the silver uptake began with a fine outline at the surface of the bodies of the late trophozoites; their cellular extensions, however, did not stain. the oblate precyst forms acquired the silver in heterogeneous patches. on spherical cysts ...19892464648
ultrastructural detection of carbohydrates in the pellicle of pneumocystis carinii.the presence of carbohydrates in the pellicle of pneumocystis carinii was demonstrated by methenamine silver (ms) and thiocarbohydrazide-silver proteinate (tch-sp) staining techniques. an intense, positive reaction with ms was observed on both the electron-dense outer layer and the electron-lucent middle layer of the pellicle, whereas in the case of tch-sp only the outer layer stained well. the middle layer did not stain as intensely with tch-sp as with ms. this observation indicates that the pe ...19882461556
combination chemotherapy and alpha-interferon in the treatment of kaposi's sarcoma associated with acquired immune deficiency syndrome.thirteen men with a median age of 37 (range 28 to 46) years who had extensive kaposi's sarcoma associated with acquired immune deficiency syndrome (aids) were treated with combination chemotherapy and alpha-interferon. four patients had stage iii disease and nine had stage iv disease (one with pulmonary and eight with gastrointestinal involvement). treatment consisted of monthly courses of actinomycin d, 1 mg/m2, and vinblastine sulfate, 6 mg/m2, given intravenously on day 1, bleomycin, 10 mg/m2 ...19882458177
human immunodeficiency virus infection in childhood.acquired immunodeficiency syndrome is associated with considerable morbidity in infants and children. it is caused by human immunodeficiency virus (hiv) which can be transmitted vertically from mother to infant early in pregnancy. transmission might also occur via breast milk. although the exact transmission rate of hiv from mother to infant is not known, hiv can become a major threat to child survival. this threat is already present in africa where high seroprevalences have been reported among ...19882456715
ultrastructural morphology and staining characteristics of pneumocystis carinii in situ and from bronchoalveolar lavage.the ultrastructure of pneumocystis carinii obtained from rats by bronchoalveolar lavage (bal) was compared with organisms in situ. all developmental forms of the organism as seen in situ were present in the lavage fluid. trophozoites in situ were adhered to type i epithelium, had smooth surfaces, and were interdigitated with the underlying epithelium. nonadherent trophozoites in situ and trophozoites in lavage fluid were more pleomorphic and irregular in shape with tubular projections extending ...19882456381
human antibody response to a strain-specific hiv-1 gp120 epitope associated with cell fusion inhibition.pepscan analysis, performed using 536 overlapping nonapeptides derived from the htlv-iii b nucleotide sequence of the region encoding the external envelope protein of 120 kda (gp120), identified in the v3 region of gp120 a major binding site for antibodies of hiv-1-infected humans. the minimal amino acid sequence of this antibody binding site was demonstrated by multiple length scanning to be five to eight amino acids in length: (g)pgraf(vt), i.e. amino acids 312-319. a peptide (neu 21) containi ...19882456084
pneumocystis carinii in sputum. comparable efficacy of screening stains and determination of cyst density.to determine whether accurate quantification of pneumocystis carinii cysts in sputum is possible using currently available means and to determine the optimal stain for screening sputum for p carinii, we undertook a comparative evaluation of readily available stains: (1) diff-quik, a stain that provides tinctorial detail comparable with giemsa, (2) toluidine blue, and (3) silver methenamine on simultaneously thawed sputum samples containing p carinii. we also studied the diff-quik stain in combin ...19882456048
passive immunoprophylaxis with specific monoclonal antibody confers partial protection against pneumocystis carinii pneumonitis in animal models.pneumocystis carinii is an important cause of pneumonitis in the immunosuppressed host. little is known, however, about the biology of this organism. this report demonstrates that a mab, m5e12, previously shown to be directed against a surface antigen that is present on rat-, rabbit-, ferret-, and human-derived p. carinii, is capable of hindering the development of p. carinii pneumonitis in animal models of this infection when administered throughout the period of immunosuppression. it appears t ...19882454947
[pneumocystis carinii: laboratory diagnosis. state of the art].in the light of the international literature and personal observation, the diagnostic techniques employed in pneumocystis carinii pneumonia (pcp), a major opportunistic infection of acquired immunodeficiency syndrome (aids) are reviewed.19882454420
rapid noninvasive diagnosis of pneumocystis carinii from induced liquefied sputum.pneumocystis carinii organisms cluster in alveolar casts. a method for concentrating alveolar casts in sputum specimens might improve the diagnostic usefulness of sputum studies in possible cases of pulmonary infection with pneumocystis carinii. the use of sputum induction to detect pneumocystis carinii was studied in 40 consecutive patients with known or suspected human immunodeficiency virus infection having bronchoscopy for evaluation of pulmonary disease. sputum produced by deep coughing ind ...19882454045
modified toluidine blue o stain for pneumocystis carinii: further evaluation of some technical factors.a modified toluidine blue o (tbo) stain for pneumocystis carinii cysts was evaluated with regard to the influence of (i) the age and extent of use of the sulfation reagent, (ii) the source of tbo, (iii) the tbo content of the staining solution, and (iv) the amount of tbo present in the alcohol wash solutions. all tbos evaluated, except for a new tbo obtained from roboz surgical instrument co., inc., washington, d.c., produced satisfactory results. each lot of tbo should be quality controlled bef ...19882452828
diagnosis of pneumocystis carinii pneumonia. 19882450152
pediatric acquired immunodeficiency syndrome with negative human immunodeficiency virus antibody response by enzyme-linked immunosorbent assay and western blot.a 5-month-old white girl having persistent oral candidiasis was brought to medical attention because of acute respiratory distress, pneumonia, and hypoxia that worsened despite supportive care and antibiotics. bronchial lavage fluid yielded pneumocystis carinii. the diagnosis of acquired immunodeficiency syndrome (aids) was suspected, although enzyme-linked immunosorbent assay (elisa) and western blot tests were both negative for human immunodeficiency virus (hiv) antibody. immunologic evaluatio ...19882449652
diagnosis of pneumocystis carinii pneumonia: improved detection in sputum with use of monoclonal antibodies.with the dramatic increase in the frequency of pneumocystis carinii pneumonia associated with human immunodeficiency virus infection, there has been a need for more rapid and less invasive diagnostic techniques. recent studies have shown that examination of induced sputum can establish the diagnosis of p. carinii pneumonia in about 55 percent of cases. to assess whether a recently developed indirect immunofluorescent stain using monoclonal antibodies was more sensitive than giemsa or toluidine b ...19882449613
possible confusion of aspergillus fumigatus and pneumocystis carinii. 19872449349
activity of lipid-soluble inhibitors of dihydrofolate reductase against pneumocystis carinii in culture and in a rat model of infection.trimetrexate and bw301u (piritrexim isethionate), lipid-soluble inhibitors of dihydrofolate reductase, are potent inhibitors of the growth of pneumocystis carinii in culture with wi-38 cells. inhibition was observed with 0.1 microgram of trimetrexate or bw301u per ml. trimethoprim is ineffective at 100 micrograms/ml in this culture system. both trimetrexate and bw301u were effective as prophylactic agents against p. carinii pneumonia in rats; trimetrexate at 7.5 mg/kg protected 9 of 10 rats, and ...19872445281
localization of silver deposits on pneumocystis carinii treated with gomori's methenamine silver nitrate stain.the question which portion of the pellicle of pneumocystis carinii is actually stained by the gomori's methenamine silver nitrate (gms) method was solved with the aid of electron microscopy. silver particles were specifically deposited on the electron-lucent middle layer of the precyst, cyst and ruptured cyst, whereas such deposition was not found on the pellicle of the trophozoite, probably due to the absence of the electron-lucent middle layer in the trophozoite. these deposits increased in pr ...19872444043
production of a monoclonal antibody with specificity for the pellicle of pneumocystis carinii by hybridoma.this study reports the establishment of cloned hybridomas between mouse myeloma cells (p3-x63-ag8, 6.5.3) and spleen cells from balb/c mice immunized with lung homogenates of nude mice (balb/c nu/nu) heavily infected with pneumocystis carinii. a hybridoma subclone, designated 1e12-8, produced antibodies of an igg1 subclass. using indirect immunofluorescent antibody techniques, the monoclonal antibody was found to be directed toward the pellicle antigen of air-dried p. carinii both in trophozoite ...19872438684
plastic embedding evaluation of pneumocystis carinii pneumonia in aids. simultaneous demonstration of cyst and sporozoite forms.to study the possible role of plastic embedding in the surgical pathologic diagnosis of pneumocystis carinii pneumonia, bronchial biopsy specimens from five patients with aids were examined using 0.9 micron thick methacrylate sections stained with silver methenamine borate and counterstained with toluidine blue. this technique was found to be superior to paraffin embedding in the demonstration of the fine structural details of both pneumocystis and the surrounding lung tissue. this method permit ...19872436496
detection of pneumocystis carinii in lung-derived samples using monoclonal antibodies to an 82 kda parasite component.monoclonal antibodies against pneumocystis carinii (pc) antigenic epitopes resistant to denaturing procedures were developed by immunization of mice with isolated parasites and a urea extract of infected human lung tissue. paraffin sections of infected lung tissue were used as antigen in the screening for reactive clones. the target antigen was identified as an 82 kda parasite specific component in immunoblotting. the antibody showed no cross-reactivity with human lung tissue and various rat tis ...19872435811
pneumocystis carinii in bronchoalveolar lavage. 19872435764
[microscopic diagnosis of pneumocystis carinii. comparison of various staining technics].the toluidine blue 0 and methenamine-silver nitrate staining techniques allowed a good microscopic distinction of pneumocystis carinii cysts in lung autoptic impression smears. poor results we observed with methylene blue and modified gram techniques. with giemsa's stain the intracystic bodies are shown, however the microscopic examination requires experience and patience.19852435598
diagnosing pneumocystis carinii. 19872433100
simultaneous demonstration of cyst walls and intracystic bodies of pneumocystis carinii in paraffin embedded lung sections using gomori's methenamine silver nitrate and giemsa stain. 19862432093
fluorescence not specific for pneumocystis carinii. 19862430392
[pneumocystis carinii pneumonia--a review].pneumocystis carinii pneumonia is a clinically, roentgenologically, and serologically uncharacteristic pneumonia of the immunodeficient patient and is caused by the opportunistic parasite pneumocystis which is most likely a protozoon. the untreated disease is lethal. the epidemiologic, clinic, and histologic features of p. carinii pneumonia are different from those of the interstitial plasmacellular pneumonia that occurred in malnourished and premature infants between 1930 and 1960 in europe and ...19862429914
diagnosing pneumocystis carinii pneumonia by cytological examination of bronchoalveolar lavage fluid: report of 15 cases.sixty episodes of pneumonia occurring in 53 immunosuppressed patients were investigated by bronchoalveolar lavage. pneumocystis carinii was diagnosed on 15 (25%) occasions. in all cases the papanicolaou stained lavage fluid presented a distinctive appearance and contained abundant, often biphasic, staining, "honeycomb" debris, and few alveolar macrophages. the grocott methenamine silver technique confirmed the presence of characteristic cystic organisms in the debris in all 15 instances. cysts c ...19862428843
[pneumocystis carinii viewed by the optical microscope. value of the chalvardjian and grawe stain]. 19862428276
the microscopic diagnosis of pneumocystis carinii. an evaluation of the gram, the methylene blue, and the ziehl-neelsen procedures.an assessment of the gram, the methylene blue, and the ziehl-neelsen procedures in diagnosing pneumocystis carinii has been performed. by using heat and methanol as fixatives and phase-contrast microscopy we found the procedures valuable in detecting the pneumocysts, especially in the gram staining. the diagnosis should, however, be confirmed by a re-staining with a specific staining, viz. the toluidine blue 0 or the silver impregnation a.m. gomori-grocott. it is additionally shown that the stai ...19862425552
cytologic detection of pneumocystis carinii: a comparison of papanicolaou and other histochemical stains.pneumocystis carinii, a common pathogen among immunocompromised patients, has been investigated in cytologic specimens using both the histochemical stains and ultraviolet (uv) fluorescence following papanicolaou staining. we reviewed 57 pulmonary cytologic specimens obtained from 23 patients and compared the results of specific histochemical stains and papanicolaou-stained preparations under uv excitation. specific pneumocystis fluorescence was observed in 26 of 49 papanicolaou-stained specimens ...19862424693
attachment of microbes to host cells: relevance of pneumocystis carinii. 19862423776
pneumocystis carinii delanoë & delanoë, 1912 found in lungs of freeliving animals in denmark at autopsy.stained imprints made from autopsy lung biopsies from hares, foxes, badgers, stone martens, one hedgehog, roe deer from denmark and from caribou from greenland were examined microscopically for pneumocystis carinii. pneumocysts were found in the lungs of 3 out of 28 hares, 3 out of 18 foxes and 1 out of 6 roe deer. this is the first report of pneumocystis carinii in hares, foxes, and roe deer in denmark. it seems to be the first report of pneumocystis carinii in roe deer.19862422628
techniques for examining pneumocystis carinii in fresh specimens.pneumocystis carinii was examined in fresh preparations of infected rat lung homogenates and tissue culture supernatants by a variety of light microscope techniques, vital dyes, and histologic stains. phase-contrast microscopy, nomarski interference-contrast microscopy, and bright-field microscopy with oblique illumination provided excellent views of p. carinii. erythrosin b, and to a lesser extent trypan blue, were helpful in assessing organism viability. the use of triton x-100-giemsa stain pe ...19862422197
morphologic criteria for the identification of pneumocystis carinii in papanicolaou-stained preparations. 19862418615
cytologic detection of pneumocystis carinii by ultraviolet light examination of papanicolaou-stained sputum specimens. 19862418614
pneumocystis carinii pneumonitis. the nature and diagnostic significance of the methenamine silver-positive "intracystic bodies".the cyst forms of pneumocystis carinii in specimens stained with methenamine silver contain single or paired discrete foci of enhanced staining that measure 1-2 micron in maximum size. the nature of these foci and their location within the cysts have been disputed. we demonstrate by electron microscopy of silver-stained sections that the darkly stained foci correspond to a focal thickening of the cyst wall and are unrelated to sporozoites and other intracystic organelles. the morphology of these ...19852415010
advantages of a modified toluidine blue o stain and bronchoalveolar lavage for the diagnosis of pneumocystis carinii pneumonia.a modified toluidine blue o staining technique for pneumocystis carinii is described. an easily prepared sulfation reagent made with sulfuric and acetic acids was used. the stain can be employed for bronchoalveolar lavages and lung tissue touch preparations. most background material was removed by the sulfation reagent, slides were generally easy to read, and time from receipt of a specimen to reporting of results was approximately 1 h. p. carinii cysts were more easily visualized with this stai ...19852414314
cytologic diagnosis of pneumocystis carinii infection by bronchoalveolar lavage in acquired immune deficiency syndrome.twenty-six patients with pulmonary infiltrates and suspected acquired immune deficiency syndrome (aids) underwent 29 fiberoptic bronchoscopies, including bronchoalveolar lavage. seventeen of the 18 patients (94.4%) shown to have pneumocystis carinii pneumonia were diagnosed by examination of the bronchoalveolar lavage specimen. minor complications occurred in 7 of 29 total bronchoscopies and included transient fever and hypoxemia. bronchoalveolar lavage is a safe, easy and effective procedure fo ...19852413675
the recognition of pneumocystis carinii in routine papanicolaou-stained smears.using definite criteria it is possible to accurately evaluate routine papanicolaou-stained cytologic smears for the presence or absence of pneumocystis carinii. strict attention must be paid to the cellular environment and the background material intimately associated with the cells. in 133 cytology specimens evaluated from proximal and deep bronchial washings and brushings, 71 were considered positive for p. carinii and 62 were called negative. ten of the latter were either unsatisfactory or eq ...19852413674
disseminated bilateral chorioretinitis due to histoplasma capsulatum in a patient with the acquired immunodeficiency syndrome.a 31-year-old white male homosexual was healthy until march 1984, when he developed pneumocystis carinii pneumonia, which resolved with treatment. in april 1984 he developed fever, followed by hepatosplenomegaly, headaches, blurred vision, pancytopenia and pulmonary infiltrates. on june 11, intracytoplasmic yeast were noted within leukocytes on a peripheral blood smear, and amphotericin b was started. the patient developed progressive respiratory and renal insufficiency and died on june 13, 1984 ...19852413418
aids and parasitic infections, including pneumocystis carinii and cryptosporidiosis.aids is a disorder that the pediatrician must consider when evaluating children with a variety of clinical conditions, including overwhelming infection with a number of parasites. this article discusses these opportunistic parasitic infections, focusing on their link with aids.19852410851
role of the microbiology laboratory in the diagnosis of opportunistic infections in persons infected with human immunodeficiency virus.patients with defects in the immune system caused by infection with human immunodeficiency virus are predisposed to a variety of opportunistic infections, many of which can be diagnosed by conventional or special microbiological procedures. this article reviews the laboratory diagnosis of bloodstream, lower respiratory tract, gastrointestinal tract, and central nervous system infections in persons infected with human immunodeficiency virus. laboratories serving health care facilities in which a ...19902407217
management of patients with asymptomatic hiv infection.there has been extensive progress in the management of hiv infection. this especially applies to patients in the early asymptomatic stages of disease. management guidelines include counseling of all seropositive patients, medical evaluation, psychological support, and medical intervention. for the asymptomatic patient, important strategies currently recommended include a cd-4 cell count at six month intervals with the use of azt for those patients with counts of less than 500/mm3 and the use of ...19902406530
problems in the detection of pneumocystis carinii by indirect immunofluorescence. 19902406144
pneumocystis carinii pneumonia in human immunodeficiency virus-infected patients.pneumocystis carinii has taken on new importance with the emergence of the human immunodeficiency virus. it is the most common life-threatening opportunistic infection in the acquired immunodeficiency syndrome and eventually develops in 80% or more of those not receiving primary prophylaxis. this review focuses on the clinical presentation, diagnosis, treatment, and prophylaxis of p carinii pneumonia in patients with human immunodeficiency virus infection.19902405800
clinical utility of liver biopsy in patients with serum antibodies to the human immunodeficiency virus.patients with the acquired immunodeficiency syndrome (aids) frequently have liver dysfunction, which may be due to a number of causes. determination of the patients who are likely to benefit from liver biopsy, an invasive procedure, is therefore important. in this study, the results of liver biopsy in patients with aids were compared to those in human immunodeficiency virus (hiv)-infected patients without aids.19902405658
the evolving challenge of pneumocystis carinii. a deadly opportunist in aids.considerable progress has been made in the identification and treatment of pneumocystis carinii pneumonia related to acquired immunodeficiency syndrome (aids). prophylaxis, either primary or secondary, represents a major advance and should be used appropriately by physicians caring for patients infected with human immunodeficiency virus. yet with success come new challenges. centers for treatment of aids that aggressively use prophylaxis have seen a shift toward severe illness due to other patho ...19902405375
reduced concentrations of igg antibodies to pneumocystis carinii in hiv-infected patients during active pneumocystis carinii infection and the possibility of passive immunisation.the relationship between pneumocystis carinii antibody concentrations and acute pneumocystis infection was investigated by testing sequential samples of serum from hiv antibody-positive patients with respiratory symptoms and hiv-negative immunocompromised patients by means of an indirect immunofluorescence assay for specific igg antibodies to p. carinii. loss of circulating antibody at the time of active pneumocystis infection was observed in five patients with proven infection. three others sho ...19902405059
kaposi's sarcoma in transfusion-associated acquired immunodeficiency syndrome. a case report and review of the literature.kaposi's sarcoma in transfusion-associated acquired immunodeficiency syndrome is rare; to our knowledge, only four previous cases have been reported. we report a unique case of transfusion-associated acquired immunodeficiency syndrome in a 74-year-old woman. at autopsy, both lungs were extensively affected by kaposi's sarcoma, pneumocystis carinii, and cytomegalovirus infection. these three processes led to respiratory failure and accounted for her death.19902403779
continuous positive airway pressure by face mask in pneumocystis carinii pneumonia.we used continuous positive airway pressure (cpap) by face mask to treat 18 aids patients with pneumocystis carinii pneumonia (pcp) who were in hypoxic respiratory failure. candidates for mask cpap were conscious, not hypercarbic, and able to protect their airway on icu admission. treatment was effective and well tolerated. mean po2 rose from 62 to 158 torr, respiratory rate decreased from 51 to 32 breath/min, and pco2 was unchanged. mean duration of treatment was 4.5 days. only one patient deve ...19902403506
outcome after assisted ventilation in children with acquired immunodeficiency syndrome.twenty-two pediatric patients with aids required assisted ventilation during 27 pediatric icu (picu) admissions. patients were retrospectively divided on the basis of whether they required assisted ventilation for acute respiratory failure (arf) or for another reason. sixteen (59%) courses of assisted ventilation were for arf. the picu mortality rate was 81% for the arf group. eleven (41%) courses of assisted ventilation were for reasons not involving arf. the picu mortality rate for the group w ...19902403505
the diagnosis of pneumonia in the immunocompromised child: use of bronchoalveolar lavage.between january 1987 and december 1988, 26 immunocompromised children (aged 15 months to 17 years) underwent bronchoalveolar lavage (bal) for evaluation of pneumonia (chemotherapy for malignancy, 12; orthotopic liver transplantation, 9; other hematologic disease, 5). bilateral diffuse pulmonary disease was present in 25 children. all were receiving broad spectrum antibiotics. in addition, five were receiving antiviral therapy and two were receiving antifungal therapy. sixteen patients underwent ...19902401943
[morphological changes in pneumocystis carinii in the alveolar space due to treatment with co-trimoxazole--comparison of clinical cases and experimental rats].in this study, transmission electron microscopy was employed to observe the morphological changes in pneumocystis carinii (p. carinii) in the alveolar space of patients and experimental rats treated with co-trimoxazole. experimentally, p. carinii pneumonia was induced in wistar rats by peritoneal injection of prednisolone and then treated with co-trimoxazole. the animals were divided into an untreated group and groups treated with co-trimoxazole for 3-9 days. in the untreated group, various form ...19902401809
long-term secondary prophylaxis of pneumocystis carinii pneumonia by inhaled pentamidine in aids. 19902401788
treatment of pneumocystis carinii choroidopathy. 19902400340
hyponatremia in patients with acquired immune deficiency syndrome.we performed prospective and retrospective studies of 96 consecutive patients with acquired immune deficiency syndrome (aids) or aids-related complex (arc) to determine the incidence, pathogenesis, and clinical significance of hyponatremia, defined as serum sodium levels less than or equal to 130 mmol/l on more than one occasion. thirty (31.3%), six with arc and 24 with aids, had hyponatremia, and it developed in 20 as outpatients. age, gender, duration of illness, and weight loss did not differ ...19902398458
pneumocystis carinii pneumonia: ct and hrct observations.we examined the chest radiography, ct, and high resolution ct (hrct) of 14 patients with proven pneumocystis carinii pneumonia. we compared the radiographic and hrct patterns of abnormal lung parenchyma with histologic sections obtained in those 11 patients who had had transbronchial lung biopsies. diffuse bilateral perihilar airspace disease was the most common radiographic pattern. both ct and hrct showed "ground glass" opacity in the lungs, through which the vessels remained visible in all pa ...19902398155
separation of pneumocystis carinii from the lung of the steroid-suppressed rat.pneumocystis carinii pneumonia was induced in rats by chronic corticosteroid immunosuppression. the parasite was separated from virtually all contaminating host cells using the technique of unit gravity sedimentation. cellular contamination was routinely below 0.02%. the same technique allowed partial separation of the cyst from the trophozoite stage.19902397880
kaposi's sarcoma in three hiv-1-infected cohorts.we describe the kaposi's sarcoma (ks) experience in three cohorts of homosexual men, subjects with hemophilia, and human immunodeficiency virus type 1 (hiv-1) seroconverters. the risk of ks was higher in hiv-1-infected homosexual men from new york city as compared with washington, d.c. and was very low in the hemophilia subjects. while ks accounted for a decreasing proportion of aids cases in homosexual men, the absolute risk per year did not diminish. survival was similar after diagnosis of ks ...19902395084
pneumocystis carinii pneumonia. the steroid dilemma. 19902393313
novel pentamidine analogs in the treatment of experimental pneumocystis carinii pneumonia.we have recently demonstrated that substitution of imidazoline moieties for the amidine groups of pentamidine produces a molecule that is effective against rat pneumocystis carinii pneumonia and that is apparently less toxic than pentamidine. for this reason, 10 novel imidazoline substituted compounds were evaluated for their effect against rat p. carinii pneumonia. while several of the new compounds were observed to have advantages over pentamidine in the treatment of disease in the rat model, ...19902393262
oral therapy for pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. a controlled trial of trimethoprim-sulfamethoxazole versus trimethoprim-dapsone.antimicrobial drugs that can be taken orally are needed for the treatment of pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome (aids). preliminary data indicate that dapsone with trimethoprim may be an effective alternative to trimethoprim-sulfamethoxazole, which is frequently toxic.19902392131
the emerging aids epidemic in ireland--clinicopathological findings in 23 early cases.a longitudinal study with follow up to the end of 1989 was carried out on 23 patients with aids who had attended st. james's hospital, dublin, by the end of 1987. until then only 33 cases of aids had been reported in ireland. the patients, all of whom had antibodies to human immunodeficiency virus (hiv), were predominantly male, young (mean age 31.3 years) and belonged about equally to three major risk groups: homosexuals, intravenous drug abusers (ivda) and haemophiliacs. aids was diagnosed bec ...19902391209
scintigraphic pattern of pneumothorax complicating pneumocystis carinii pneumonia in patients with aids.spontaneous pneumothorax is a serious though infrequently reported pulmonary complication of aids. an unsuspected lung collapse was discovered via gallium scintigraphy for the study of pneumocystis carinii pneumonia. neither the pneumonia nor the pneumothorax were apparent on the most recent chest roentgenogram. in evaluating gallium images during the work-up of aids patients with associated pulmonary pathology, the possible complication of lung collapse should be considered. if pneumothorax is ...19902390822
anti-cardiolipin antibodies and hiv infection.anti-cardiolipin antibodies of igg class were found in 48% of intravenous drug users, 38% of homosexuals and 14% of heterosexuals (with no other risk factor) infected with hiv. anti-cardiolipin antibodies were not increased in hiv-negative heterosexual partners of hiv-infected patients, but mildly elevated levels were detected in hiv-negative drug users, relative to healthy controls unselected for hiv status. among hiv infected drug users, anti-cardiolipin antibodies were not associated with thr ...19902387093
molecular probes for the detection of pneumocystis carinii. 19902385864
impact of aids on mortality in san francisco, 1979-1986.we used death certificate data for san francisco residents from 1979 to 1986 to calculate the number of deaths and years of potential life lost before age 65 (ypll) for leading causes of death. acquired immune deficiency syndrome (aids)-related deaths were defined as including cytomegalovirus infection (icd-9 078.5); cryptococcal infection (icd-9 117.5); pneumocystis carinii pneumonia (icd-9 136.3); other malignant neoplasms of the skin, site unspecified (icd-9 173.9); deficiency of cell-mediate ...19902384868
anticardiolipin antibodies and pneumocystis carinii pneumonia in patients with aids. 19902384678
gas chromatographic determination of trimethoprim in plasma during high-dose trimethoprim-sulfamethoxazole treatment for pneumocystis carinii pneumonia. 19902384559
severe community-acquired pneumonia. etiology, prognosis, and treatment.the frequency of community-acquired pneumonia coupled with its mortality rate of 10 to 25% is of growing concern to clinicians. a prospective study of 67 patients with severe community-acquired pneumonia was carried out to determine the causative agents, the impact fore-knowledge of the etiology has on the outcome, the value of clinical and radiologic criteria in predicting the evolution, and the efficacy of empirical therapy. the study group included 45 men and 22 women (mean age: 56.8 +/- 16.6 ...19902382902
acquired immunodeficiency syndrome and pneumocystis carinii infection in a pregnant woman.human immunodeficiency virus (hiv) infections are being seen with greater regularity by the obstetrician-gynecologist. acquired immunodeficiency syndrome (aids), the extreme of the spectrum of hiv infections, is associated with pneumocystis carinii infection in more than half of newly diagnosed cases. four cases of aids and p carinii pneumonia complicating pregnancy have been reported in the literature, and all have caused maternal death. we report a case in which the mother survived. treatment ...19902381630
application of immunoblotting to detect soluble pneumocystis carinii antigen(s) in bronchoalveolar lavage of patients with pneumocystis pneumonia and aids.the technique of immunoblotting for detecting soluble pneumocystis carinii antigen(s) in bronchoalveolar lavage fluid specimens from patients with aids and pneumocystis pneumonia was evaluated. a soluble 67 kilodalton polypeptide that was immunoreactive with an anti-p carinii monoclonal antibody (2g2) was found in the supernatants of 26 lavage samples from patients with pneumocystosis. intact organisms in lavage sediments were detected by methenamine silver or immunofluorescence staining procedu ...19902380406
plasma fibronectin concentrations in patients with human immunodeficiency virus infection.plasma fibronectin (pfn) concentrations were assessed in 21 patients with aids, in seven with aids-related complex (arc), in 17 asymptomatic seropositive patients, and in 36 age and sex matched healthy control subjects. a single radial immunodiffusion technique was used to determine pfn concentration. a significant decrease in pfn concentrations was observed in patients with arc and aids (especially in those patients with pneumocystis carinii pneumonitis). on the other hand, normal pfn concentra ...19902380404
semiquantitative technique for estimating pneumocystis carinii burden in the lung.we developed a technique to estimate the amount of pneumocystis carinii found in bronchoalveolar lavage fluid. p. carinii associated with 500 nucleated cells in the bronchoalveolar lavage fluid had little between-observer and within-observer variation. varying the technique of the lavage did not change the amount of p. carinii recovered. this technique was used in patients treated for p. carinii pneumonia. those patients who did not respond to treatment had more p. carinii in their bronchoalveol ...19902380366
growth and metabolism of pneumocystis carinii in axenic culture.recent analyses of rrna have suggested a taxonomic relationship of pneumocystis carinii with fungi. we investigated various liquid and solid media without feeder cells for the ability to support growth of p. carinii. organisms were obtained from the lungs of immunosuppressed rats and separated from host cells by treatment with hypotonic solutions and a series of microfiltrations. the growth of p. carinii was quantitated by staining nuclei with diff-quik. optimal replication was observed in media ...19902380365
pneumocystis carinii choroiditis after long-term aerosolized pentamidine therapy.pneumocystis carinii pneumonia is a major cause of morbidity and mortality in patients with the acquired immunodeficiency syndrome. when p. carinii is disseminated, the choroid may be involved and the infection is often fatal. we examined, treated, and followed up two patients who developed choroidal lesions typical of p. carinii while taking aerosolized pentamidine for prophylaxis. the choroidal lesions gradually resolved after three weeks of therapy with intravenous trimethoprim and sulfametho ...19902378374
[herpes simplex infections in patients with aids].herpes type infections in aids patients tend to be more severe, generalized and have a torpid evolution. we present here two cases of intravenous drug addicts with a clinical picture of ulcerative lesions with a scar in the perioral and ungual regions with an evolution of several months an which were diagnosed of herpes simplex by a histopathological study. they were treated with intravenous acyclovir achieving a complete remission; one patient developed a pneumocystis carinii pneumonia a month ...19902377775
[the value of fiberoptic bronchoscopy in diagnosis of hiv associated infections].32 patients with hiv infection presenting with fever or abnormal chest radiograph or both were investigated at the university hospital of mainz (frg). fiberoptic bronchoscopy with bronchoalveolar lavage and transbronchial biopsy was undertaken in each patient, additionally other methods were used for isolating pathogens (i.e. urine sample, stool and blood culture etc.). in 26 patients one or more complicating diseases were documented, in six persons no reason for fever or pulmonary symptoms coul ...19902377146
[clinicopathological study of miliary tuberculosis in patients with hematologic disease].seven cases of miliary tuberculosis in patients with hematologic disease were analyzed clinicopathologically. mean age of the patients was 65 years, and the hematologic diseases were cml, aml, all, mds and malignant lymphoma. diabetes mellitus was present as a complication in three patients. miliary tuberculosis was found in 5 cases during the first admission to our hospital owing to hematologic problems. in 4 of 6 cases, fever had started more than two months before admission, consequently, the ...19902376932
[pneumonia: special course in aids. pneumocystis carinii pneumonia--inhalation therapy]. 19902376388
progressive resistance exercise: effect on muscle function and anthropometry of a select aids population.substantial body tissue wasting has been reported in acquired immune deficiency syndrome (aids) patients. the purpose of this investigation was to determine if progressive resistance exercise (pre) would improve muscle function and increase body dimensions and mass in aids patients. the subjects were 24 male outpatient volunteers, status posttherapy for acute pneumocystis carinii pneumonia. subjects were randomly assigned to control (n = 12) or experimental (n = 12) subsets. all subjects underwe ...19902375667
a case of pneumocystis carinii in pleural fluid with cytologic, histologic and ultrastructural documentation.pneumocystis carinii involvement of the pleural cavity in a patient with the acquired immune deficiency syndrome was documented by cytologic as well as scanning and transmission electron microscopic study of pleural fluids. histologic examination of the pleura and the subpleural lung revealed vasculitis and infarctlike necrosis as well as p carinii in the tissue. although a few cases of extrapulmonary p carinii infection have been reported, this appears to be the first time its presence in pleur ...19902375218
[initial experiences with pentamidine aerosol in prevention of pneumocystis carinii pneumonia following bone marrow transplantation].after bone marrow transplantation there is a risk of 10% to acquire a pneumonia caused by pneumocystis carinii, if no prophylaxis is used. so far cotrimoxazol is the treatment of choice from day -14 before to day +180 after bone marrow transplantation. this substance, however, may cause allergic reactions, may augment the risk of nephrotoxicity of other drugs, and may be myelosuppressive. the prophylaxis with pentamidine-inhalation was used in 26 patients after bone marrow transplantation so far ...19902374531
[prospective study of primary and secondary prevention of pneumocystis carinii pneumonia with pentamidine aerosol].in an open prospective study in the aids outpatient department of the frankfurt university clinic the efficacy of pentamidine aerosol at a dosage of 200 mg every 14 days in the primary and secondary prophylaxis of pneumocystis carinii pneumonia was tested. the incidence of pneumocystis carinii pneumonia was reduced by more than 75% in the group of patients receiving pentamidine additionally by inhalation as compared with a historical cohort given azidothymidine alone. the results of the study su ...19902374530
[comparison of the effect of 2 therapy concepts in the treatment of pneumocystis carinii pneumonia. cotrimoxazole for 21 days versus sequential therapy with cotrimoxazole followed by pentamidine inhalation].standard therapy of pneumocystis carinii pneumonia with cotrimoxazole and intravenous pentamidine second line therapy both have a response rate of 75 to 90%. as severe side effects, myelotoxicity and skin reaction have been observed which may occur from treatment day 7 on. in order to prevent such side effects as well as reduce hospitalization times, an open, randomized pilot study was designed. object of this study was the comparison of efficacy and safety of two different treatment schemes: st ...19902374529
[autoradiography study of organ distribution of 14c pentamidine following intravenous and inhalational administration in rats].the organ distribution of 14c pentamidine was studied in sprague dawley rats by means of whole-body autoradiography following intravenous application and inhalation of aerosolized pentamidine. the distribution time after intravenous administration of 5 mg pentamidine per kg rat was 30 minutes, six hours, 24 hours, and seven days respectively. the corresponding times after administration of aerosolized pentamidine were 30 minutes and 24 hours. by measuring radioactivity in punch specimens of 100 ...19902374526
[pentamidine inhalation for therapy and prophylaxis of pneumocystis carinii pneumonia. results of the working discussion of the section for antiparasite chemotherapy of the paul ehrlich society]. 19902374525
multiple pneumatocoeles and bilateral tension pneumothoraces complicating pneumocystis pneumonia in aids.pneumatocoele and pneumothorax are uncommon complications of pneumocystis carinii pneumonia. we report a patient with the acquired immune deficiency syndrome who developed multiple bilateral pneumatocoeles which we demonstrate to have ruptured leading to the subsequent bilateral tension pneumothoraces and to death. the computerised tomographic appearances, and histopathology of these unusual complications are presented. the literature on these manifestations is reviewed and management discussed.19902372278
infection of the heart by the human immunodeficiency virus.heart muscle disease in the acquired immune deficiency syndrome (aids), characterized by electrocardiographic changes or congestive cardiomyopathy, is a documented clinical problem, but its pathogenesis is obscure. in aids the heart is known to be involved by a variety of opportunistic infections as well as kaposi's sarcoma, but no causative relation with the development of cardiomyopathy has been established. this study reports evidence for direct infection of the heart in aids, not by an oppor ...19902371952
aerosolised pentamidine (ap) prophylaxis for pneumocystis carinii pneumonia (pcp) using a low cost jet nebulising system. 19902371552
a patient with acquired immune deficiency syndrome (aids) and pneumocystis carinii pneumonia who developed bilateral pneumothoraces. 19902371445
the relation between resource use and in-hospital mortality for patients with acquired immunodeficiency syndrome-related pneumocystis carinii pneumonia.a central issue in health policy with regard to the acquired immunodeficiency syndrome (aids) is whether quality of care and patient outcomes are affected by resource constraints. in an earlier study of 15 california hospitals between october 1986 and october 1987, we observed a markedly lower in-hospital mortality rate for pneumocystis carinii pneumonia in the group of patients treated in hospitals that had a high level of experience with aids relative to the group treated in hospitals with low ...19902369243
[intensive care problems in aids patients].the discussion regarding the need for intensive-care treatment of aids patients should be conducted in a highly differentiated manner and should depend on the prognosis of the underlying or basic disease, on the immunological situation, on the mental condition and on the consent of the individual patient. during the past two years the treatment results have improved markedly by the use of steroids, especially in pneumocystis carinii pneumonia.19902367423
[hiv-associated infections: indications and importance of fiberoptic bronchoscopy].in 32 patients infected with hiv with unclear fever and/or pulmonary infiltraes, a fiberbronchoscopy (fb), with transbronchial lung biopsies (tbb) and bronchoalveolar lavage (bal) was carried out. thirteen of these patients had pneumocystis carinii pneumonia (pcp), three patients tuberculosis of the lungs, two patients pneumococcal pneumonia, and one patient each had a staphylococcal pneumonia, an enterobacter cloacae pneumonia, and an unspecific alveolitis. thus, 66% of the patients proved diag ...19902367404
complications of corticosteroid therapy in patients with the acquired immunodeficiency syndrome and pneumocystis carinii pneumonia.we retrospectively studied the acute toxicity of corticosteroid therapy in 23 episodes of pcp occurring in the setting of aids and determined the incidence of hiv-related complications following these and 16 other contemporaneous episodes of aids-related pcp treated with antimicrobials alone. the mean duration of corticosteroid therapy was 5.4 days and the mean total dose was 660 mg of methylprednisolone. cryptococcus neoformans and listeria monocytogenes infection each occurred once within one ...19902361410
experience with home aerosolized pentamidine treatment in patients with aids.pneumocystis carinii pneumonia (pcp is the most frequent opportunistic infection in patients with aids and is the most common cause of death in these patients. conventional parenteral trimethoprim/sulfamethoxazole or parenteral pentamidine treatment is often not completed because of frequent incidence of adverse reactions. aerosolized pentamidine appears to be better tolerated and is considered an alternative treatment for pcp in both hospital and community settings. this report describes our ex ...19902360337
alveolar macrophages in aids patients: increased spontaneous tumour necrosis factor-alpha production in pneumocystis carinii pneumonia.in order to assess the role of alveolar macrophages and their products in the control of pneumocystis carinii pneumonia (pcp) and other infections in aids, bronchoalveolar lavage cells and peripheral blood mononuclear cells from hiv-positive aids/arc patients (with and without pcp) and hiv-negative patients were counted and cultured in vitro; spontaneous and lps-induced tumour necrosis factor-alpha (tnf-alpha) production was measured. markedly increased spontaneous tnf-alpha production by alveol ...19902357841
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