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diagnosis of pneumocystis carinii pneumonia by cytologic examination of bronchial washings.during the last three years, bronchial washings from patients in whom pneumocystis carinii pneumonia was clinically suspected were cytologically examined. these were predominantly cases of suspected or confirmed acquired immunodeficiency syndrome. to determine the effectiveness of cytologic diagnosis by means of a bronchial wash, retrospective analysis of bronchial washings with available simultaneous transbronchial biopsy specimens was carried out in 181 cases. comparison of the results of both ...19853876454
cell population obtained by bronchoalveolar lavage in pneumocystis carinii pneumonitis.in the course of bronchoalveolar lavages performed in 115 immunocompromised patients in order to investigate the occurrences of pneumonitis, pneumocystis carinii pneumonia was diagnosed by demonstration of cysts in bronchoalveolar lavage specimens from 11 patients. the cellular phenomena associated with p. carinii infection at the level of the alveolar space were evaluated. differential cell counts on bronchoalveolar lavage preparations stained by the may-grünwald-giemsa method were performed in ...19853876677
the acquired immune deficiency syndrome: problems associated with the management of pneumocystis carinii pneumonia.four fatal and two non-fatal cases of pneumonia caused by pneumocystis carinii and one case of co-trimoxazole-responsive interstitial pneumonia, all in homosexual patients with the acquired immune deficiency syndrome, are described. the lack of clinical signs in the chest and of abnormal radiological findings at presentation in three of the six patients with p. carinii infection, the rapidly progressive course of the disease, as well as the need for early diagnosis and treatment are stressed. th ...19853877121
disseminated sporothrix schenckii infection with arthritis in a patient with acquired immunodeficiency syndrome.patients with the acquired immune deficiency syndrome are susceptible to a wide spectrum of opportunistic infections. we report a 34-year-old man who developed systemic sporotrichosis involving the skin and joints, and whose illness terminated in subacute encephalopathy and pneumocystis carinii pneumonia. fungal arthritis is another infection to which patients with this syndrome are subject.19853877169
utility of gallium67 scintigraphy and bronchial washings in the diagnosis and treatment of pneumocystis carinii pneumonia in patients with the acquired immune deficiency syndrome.twenty patients with the acquired immune deficiency syndrome (aids) and suspected pneumocystis carinii pneumonia were evaluated by gallium67 (ga67 scintigraphy and fiberoptic bronchoscopy for initial diagnosis and response to therapy. lung uptake of ga67 was demonstrated in 100% of aids patients with p. carinii pneumonia, including those with subclinical infection. fiberoptic bronchoscopy identified p. carinii in the bronchial washings of 100% of cases (19 patients), whereas only 13 of 16 (81%) ...19853877481
pneumocystis carinii pneumonia radiographically simulating tuberculosis.eight immunocompromised patients presented with upper lobe infiltrates that radiographically simulated tuberculosis. bilateral lobar consolidation was present in 5, and apical or posterior segmental consolidation was present in 3. pneumocystis carinii was diagnosed in 7 patients from material obtained at bronchoscopy after sputum stained for mycobacteria had been negative. in the eighth patient, sputum submitted for cytologic evaluation demonstrated p. carinii. the 7 patients surviving this epis ...19853877484
gallium-67 scintigraphy in acquired immune deficiency syndrome complicated by pneumocystis carinii pneumonia. 19853877590
radiographic features in patients with pulmonary manifestations of the acquired immune deficiency syndrome.the radiographic findings in 14 episodes of pulmonary pathology, occurring in 13 patients with the acquired immune deficiency syndrome (aids) are described. the patients presented over a 15-month period. all were homosexual men with serum antibodies to human t-cell lymphotrophic virus iii. pneumocystis carinii pneumonia was the most common manifestation, occurring in seven of the 14 episodes. radiographic appearances in five of these were classical, with bilateral perihilar ground-glass shadowin ...19853877604
evaluation of patients with the acquired immunodeficiency syndrome (aids) by fiberoptic bronchoscopy.hospital records were reviewed on 78 consecutive patients (33 homosexuals, 37 haitians and 8 iv drug abusers) who had aids and who underwent fiberoptic bronchoscopy over a two year period. pneumocystis carinii pneumonia (pcp) was the most common bronchoscopic finding (53.8% of patients) followed by tuberculosis (14.1%), cytomegalovirus infection (12.8%) and atypical mycobacteriosis (3.8%). in 15.4% of patients multiple organisms were found. twenty-seven percent of patients had non-diagnostic bro ...19853877629
serological observations of pneumocystis carinii infection in humans.serological examinations of pneumocystis carinii antigen and antibody were performed in adult patients with p. carinii pneumonia. the antibody titer was assayed by indirect immunofluorescence, and antigenemia was detected by counterimmunoelectrophoresis. profiles of the time course of antibody levels in serum indicated that development of the antibody occurred at an early stage of pneumonia and that peak titers were obtained during the febrile stage.19853877736
pentamidine treatment of pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. association with acute renal failure and myoglobinuria.a 31-year-old man with acquired immunodeficiency syndrome and biopsy-proved pneumocystis carinii pneumonia developed acute renal failure, elevated creatinine kinase levels, and myoglobin in both serum and urine while being treated with pentamidine. the patient was receiving no other nephrotoxic medications at the time, and these unusual complications were directly related to the pentamidine.19853878136
[pneumocystis carinii in the bone marrow].pneumocystis carinii is observed in the bone marrow of two adults immuno-compromised; the initial diseases are on the one hand a hodgkin's disease, on the other hand a malignant lymphoma for immunocytoma type, which necessitate heavy and invalidating treatments. a pneumocystis carinii pneumonia with respiratory distress seems to have carrying away two patients death. eventually pathogenic part of the parasite in the bone marrow localization.19853878233
[acquired immunodeficiency syndrome in a child of swiss origin whose mother died from aids].report of a now 2 8/12-year-old girl, who presented at the age of 8 months with chronic progressive pneumonia, mucocutaneous candidiasis, diarrhea, failure to thrive and a non-progressive paraplegia. the child's mother presented aids with pneumocystis carinii pneumonia and progressive general paralysis one year after the beginning of the child's disease and died within a few months. additional findings in the child include lymphopenia, hyperimmunoglobulinemia, cutaneous anergy and an abnormal t ...19853878345
disease manifestation among homosexual men with acquired immunodeficiency syndrome: a possible role of nitrites in kaposi's sarcoma.to identify risk factors that determine the major manifestations of the acquired immunodeficiency syndrome (aids), the authors analyzed data from three epidemiologic studies conducted by the centers for disease control. the authors compared patients by outcome of disease. eighty-seven homosexual patients (47 with kaposi's sarcoma, 20 with pneumocystis carinii pneumonia, and 20 with both) had participated in the earlier studies, and their interviews and laboratory test results were available. com ...19853878602
[detection of pneumocystis carinii in bronchoalveolar lavage. technic and results]. 19853879164
[five cases of pneumocystis carinii pneumonia diagnosed by bronchofiberscopy--the usefulness of the bronchoalveolar lavage for diagnosis of pneumocystis carinii pneumonia]. 19853879311
[identification of pneumocystis carinii in a patient dying of aids].we compared two different techniques in the preparation of slides for the demonstration of pneumocystis carinii in lung tissue of a patient died for aids. the impressions were prepared by imprinting the autopsy tissue surfaces on glass slides, while the concentrates were prepared by a partial homogenization and subsequent centrifugation of the pulmonary tissue. after staining, the number of protozoa microscopically observed resulted similar with both techniques; moreover using impression smears ...19853879892
comparison of processing techniques for detection of pneumocystis carinii cysts in open-lung biopsy specimens.methenamine silver stain was used to compare the number of cysts of pneumocystis carinii contained in lung concentrate smears of homogenized lung tissue with the number in impression smears. results were also compared with histopathological examination of methenamine silver-stained paraffin-embedded sections. of slides from 23 preparations, a greater number of cysts were contained in concentrate smears than in impressions (p less than 0.001). in four preparations, cysts were noted in concentrate ...19853882742
acute respiratory failure due to pneumocystis carinii pneumonia: clinical, radiographic, and pathologic course.the clinical, radiographic, and pathologic correlates of acute respiratory failure due to pneumocystis carinii pneumonia were studied in 12 renal transplant patients treated with cyclosporin (cs) and prednisone. six patients required only supplemental oxygen, while the other six patients developed the adult respiratory distress syndrome (ards) requiring prolonged mechanical ventilation despite similar predisposing factors and prompt initiation of therapy. ten (83%) patients survived. increased f ...19853884275
pneumocystis carinii pneumonia. 19853884451
use of trimethoprim-sulfamethoxazole to prevent bacterial infections in children with acute lymphoblastic leukemia.we assessed the efficacy of prophylactic antibiotics in children receiving intensive chemotherapy for acute lymphoblastic leukemia. the patients were randomized to receive either trimethoprim-sulfamethoxazole (tmp-smx) or placebo in a double-blind trial. thirty patients were evaluated in each group. children receiving tmp-smx had fewer episodes of bacteremia (0 vs. 5) and otitis media (3 vs. 18). the geometric mean of the neutrophil nadir was 172 in the tmp-smx group and 287 in controls. however ...19853889875
[pneumocystis carinii pneumonia: a review]. 19853891249
pneumocystis carinii: growth variables and estimates in the a549 and wi-38 va13 human cell lines.recent studies indicate that rat pneumocystis carinii can be propagated in the a549 cell line, an alveolar epithelioid cell line derived from human lung carcinoma. in the present study, growth of p. carinii was compared in the a549 cell line and the wi-38 va13 subline 2ra, an sv40 transformed derivative of the human fetal fibroblast cell line with epithelioid morphology. similar p. carinii growth occurred in both cell lines under optimal conditions, but the wi-38 va13 cell line was usually more ...19853894045
[pneumocystis carinii pneumonia]. 19853897099
pneumocystis carinii pneumonia. 19853898464
pentamidine for the treatment of pneumocystis carinii pneumonia and other protozoal diseases.pentamidine isethionate, discovered to have antiprotozoal activity in 1938, has recently been approved in the united states for the treatment of pneumocystis carinii pneumonia. despite frequent adverse reactions, which are at times life-threatening, pentamidine remains an important alternative to trimethoprim-sulfamethoxazole for the treatment of p. carinii pneumonia in patients with a history of allergy to sulfonamides or who have severe reactions or a lack of response to treatment with trimeth ...19853901852
pentamidine isethionate in the treatment of pneumocystis carinii pneumonia.the chemistry, antiprotozoal activity, pharmacology, clinical efficacy, adverse effects, dosage, administration, and hospital formulary considerations of pentamidine isethionate are reviewed. pentamidine, an aromatic diamidine, has been used since the 1940s to treat a variety of protozoal infections. it is now most commonly administered in the treatment of pneumocystis carinii pneumonia (pcp). it is generally not metabolized, and it is stored or bound to tissue and excreted slowly as the parent ...19853902329
pentamidine: a review.pentamidine, recently released for clinical use, is effective in therapy for the hemolymphatic stage of gambian trypanosomiasis, antimony-resistant leishmaniasis, and pneumocystis carinii pneumonia. the mechanism of action is unclear and may differ for different organisms. trypanosomes actively transport pentamidine intracellularly, and the drug may then interfere with dna biosynthetics. however, pentamidine appears to kill nonreplicating p. carinii. the mechanism of killing is unexplained. the ...19853903942
pneumocystis carinii pneumonia in renal transplant recipients--clinical and radiographic features, diagnosis and complications of treatment.six episodes of pneumocystis carinii pneumonia in five renal transplant patients on low dose maintenance prednisolone are described. the infection was rare, occurring in 3 per cent of the recipients transplanted between 1978 and 1984. diagnosis and treatment were not straightforward. fever was the earliest evidence of illness, and in three episodes the chest radiograph was normal at presentation. at diagnosis, two to 16 days later, all had pulmonary infiltrates and severe hypoxia. diagnosis was ...19853909201
[pneumocystis carinii infections].in children, pneumocystis carinii pneumonias occur mainly in cases of congenital or acquired immunodeficiencies. definitive diagnosis rests on the visualization of the parasites, ideally by broncho-alveolar lavage. if the lavage is negative and the patient deteriorates, an open lung biopsy is the next best diagnostic method. serological methods are unreliable. treatment with trimethoprim-sulfamethoxazole (tmp) should be instituted as early as possible: a serum level of tmp between 5 and 10 micro ...19853914245
infections in immunocompromised patients. i. pathogenesis, etiology, and diagnosis.granulocytopenia is the major factor predisposing cancer patients to infection, chiefly by bacteria. most of the infections are caused by gram-negative aerobic organisms (escherichia coli, pseudomonas aeruginosa, and klebsiella sp) that arise from endogenous gastrointestinal, mucosal, or cutaneous flora (often modified by hospital-acquired pathogens). some fungi (candida sp and aspergillus sp) are also likely to invade granulocytopenic patients. the next most important factor predisposing cancer ...19853914372
respiratory and pulmonary alterations in experimental pneumocystis carinii pneumonia in rats.pneumocystis carinii (p.c.) pneumonia was induced in 40 rats by a prolonged corticosteroid treatment (group 1); 40 healthy rats of equal weight constituted the control group (group 2); 9 rats received the same corticosteroid treatment as group 1, together with trimethoprim-sulfamethoxazole (tmp-sfz) in order to prevent p.c. multiplication (group 3). we could distinguish the respiratory effects induced by corticosteroids from those caused by p.c. pneumonia (group 3 vs group 1). for six weeks the ...19853919791
serum lactate dehydrogenase levels in adults and children with acquired immune deficiency syndrome (aids) and aids-related complex: possible indicator of b cell lymphoproliferation and disease activity. effect of intravenous gammaglobulin on enzyme levels.twenty-seven of 33 patients with the acquired immune deficiency syndrome (aids) or aids-related complex (16 adults and 17 children) demonstrated significant elevation of serum lactate dehydrogenase activity, occurring in the isomorphic distribution. serum lactate dehydrogenase activity was the highest in all nine patients with acute pneumocystis carinii pneumonitis, in seven of whom extensive interstitial pulmonary infiltrates with lymphocytes and plasma cells were documented. lactate dehydrogen ...19853922219
pneumonia in the acquired immune deficiency syndrome.to data there have been 130 cases of the acquired immune deficiency syndrome (aids) in britain. aids is though to be caused by the retrovirus human t cell lymphotropic virus iii/lymphadenopathy associated virus (htlv-iii/lav). the presenting feature of aids may be and acute pneumonic illness with cough, breathlessness, and fever. nearly always, however, there is a preceding history of several months' ill health characterized by loss of weight, intermittent of prolonged fever, and malaise. th ...19853922466
impact of cyclosporine on renal transplant practice at the university of texas medical school at houston.csa has improved the outcome of renal allotransplantation with cad and lrd kidneys. csa mitigates risk factors heretofore presenting substantial obstacles to cad transplantation: hla matching, pretransplant splenectomy, extensive numbers of conditioning blood transfusions, and old age. in lrd transplantation, csa obviates the need for donor-specific transfusions in the haploidentical situation, and for prednisone in the hla-identical setting. the incidence of drug-induced nephrotoxicity beyond s ...19853925760
diagnostic value of pulmonary gallium 67 scanning in the diagnosis of pneumocystis carinii pneumonia in an immunocompromised patient with unexplained fever and hypoxemia. 19853929167
pneumocystis carinii pneumonia in the patient with aids. 19853931990
[a case of pneumocystis carinii pneumonia successfully treated with co-trimoxazole and pentamidine for intravenous injection]. 19853932539
a cluster of pneumocystis carinii infections in children. 19853935241
method of testing the susceptibility of pneumocystis carinii to antimicrobial agents in vitro.rat pneumocystis carinii grown on lung-derived cell lines in tissue culture flasks and multiwell plates was tested for susceptibility to four antimicrobial agents currently being used in the treatment of human pneumocystosis. standard criteria for organism quantitation, replication, viability, and inoculum size were established. trimethoprim-sulfamethoxazole inhibited p. carinii growth at a concentration ratio of 1:19 microgram/ml, and pentamidine isethionate was active at 0.1 microgram/ml. alph ...19853936409
bronchoalveolar lavage in heart-lung transplantation.distinguishing lung rejection from infection in patients who have undergone heart-lung transplantation is difficult. since bronchoalveolar lavage has been safely used to investigate other pulmonary conditions, its safety and the value of the cellular data obtained were evaluated on 44 occasions in ten heart-lung transplant recipients. this study established that bronchoalveolar lavage is safe after heart-lung transplantation, that it reliably diagnoses infection, and lastly that serial lavages a ...19853939650
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
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
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
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
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
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
pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome (aids). diagnosis with bronchial brushings, biopsy, and bronchoalveolar lavage.sixty-one diagnostic biopsies for pneumocystis carinii pneumonia were performed on 40 homosexual male patients with acquired immunodeficiency syndrome (aids), using flexible fiberoptic bronchoscopy. bronchial brushings and bronchoalveolar lavage were performed in conjunction with the biopsy in 58 and 29 bronchoscopies, respectively. using a rapid methenamine silver stain, p carinii pneumonia was diagnosed in 27 (68 percent) of the patients. twenty of these patients had a repeat biopsy one or mor ...19852580669
[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
difluoromethylornithine for pneumocystis carinii? 19852859450
adverse reactions associated with pyrimethamine-sulfadoxine prophylaxis for pneumocystis carinii infections in aids. 19852860516
opportunistic lymphoproliferations associated with epstein-barr viral dna in infants and children with aids.two types of lymphoproliferative disease associated with epstein-barr viral (ebv) dna--central-nervous-system lymphoma and chronic lymphocytic interstitial pneumonitis (lip)--were recognised in children with human t-lymphotropic virus type iii/lymphadenopathy virus infection and the acquired immunodeficiency syndrome (aids). eight of ten lung biopsy specimens from children with lip contained ebv dna. ebv dna was not identified in lung biopsy specimens with pneumocystis carinii, cytomegalovirus, ...19852867394
value of open-lung biopsy in 87 immunocompromised patients with pulmonary infiltrates.the authors performed a retrospective analysis of 87 consecutive immunocompromised patients who underwent open-lung biopsy at the university of utah medical center, salt lake city, utah, from january 1971 to june 1982. a specific histologic diagnosis was obtained in 62 (71%) of the patients, 33 of whom had infections. pneumocystis carinii was the most common microbial pathogen (16 patients), but no cases have been observed since 1980 when the routine use of prophylactic trimethoprim/sulfa began. ...19852981147
acquired immune deficiency syndrome in childhood.the acquired immunodeficiency syndrome has been observed with increasing frequency in children with associated hemophilia, high-risk environmental backgrounds, and blood transfusions. aids should be considered in the differential diagnosis of childhood immunodeficiency, and it must be distinguished from congenital disorders. we emphasize the importance of epidemiologic, clinical, and laboratory data in diagnosis and aggressive management of infectious complications. the relationship between huma ...19852982008
listeria monocytogenes sepsis and small cell carcinoma of the rectum: an unusual presentation of the acquired immunodeficiency syndrome.a 26-year-old male homosexual initially presented with listeria monocytogenes sepsis and a small cell carcinoma of the rectum. his subsequent course included esophageal candidiasis, pneumocystis carinii pneumonia, and severe t-lymphocyte abnormalities on immunologic testing, consistent with the acquired immunodeficiency syndrome (aids). this represents the first case of aids associated with this unusual tumor and listeria infection.19852983527
spectrum of pulmonary diseases associated with the acquired immune deficiency syndrome.over a four-year period, 130 patients with the acquired immune deficiency syndrome were studied to assess the incidence and spectrum of pulmonary disease associated with this illness. in 61 patients (47 percent), respiratory abnormalities were either present on admission or later developed. multiple pathologic processes were present simultaneously in 24 patients and serial pulmonary problems developed in seven patients. infection was the most common cause of pulmonary parenchymal disease and was ...19852983548
retrovirus-like particles in salivary glands, prostate and testes of aids patients.aids associated retrovirus-like particles were identified in the salivary gland, prostate and/or testicle of two aids patients. these findings further suggest that saliva and semen may transmit the infection to susceptible individuals.19852984694
bronchoalveolar lavage and transbronchial biopsy for the diagnosis of pulmonary infections in the acquired immunodeficiency syndrome.the efficacy of bronchoalveolar lavage and transbronchial biopsy in diagnosing lung infection was determined in 276 fiberoptic bronchoscopic examinations done on 171 patients with known or suspected acquired immunodeficiency syndrome. of 173 pathogens (pneumocystis carinii, cytomegalovirus, mycobacterium avium-intracellulare, cryptococcus neoformans, m. tuberculosis, coccidioides immitis, and histoplasma capsulatum) identified during the initial evaluation or in the subsequent month, the initial ...19852986505
simultaneous occurrence of pneumocystis carinii pneumonia, cytomegalovirus infection, kaposi's sarcoma, and b-immunoblastic sarcoma in a homosexual man.the most common manifestations of the acquired immunodeficiency syndrome include pneumocystis carinii pneumonia and/or kaposi's sarcoma. high-grade b-cell lymphomas have also been reported in homosexual men at risk for the acquired immunodeficiency syndrome. we herein present the case of a homosexual man, who presented simultaneously with pneumocystis carinii pneumonia, acute cytomegalovirus infection, kaposi's sarcoma, and b-cell immunoblastic sarcoma. severe compromise of both the b- and t-cel ...19852987560
immediate causes of death in acquired immunodeficiency syndrome.we evaluated the immediate causes of death in 54 adults who underwent an autopsy and were diagnosed as having died of the acquired immunodeficiency syndrome between april 1980 and october 1983. the study group included 25 haitians, 19 homosexual men, five intravenous drug abusers, two hemophiliacs (type a), and three with no known risk. fourteen died of central nervous system diseases: 11 of toxoplasma encephalitis, one of progressive multifocal leukoencephalopathy, one of viral encephalitis, an ...19852990379
therapeutic approaches to patients with aids.the immune systems of patients with acquired immunodeficiency syndrome are characterized by a profound defect in the number and function of helper/inducer t-lymphocytes, particularly at the level of soluble antigen recognition. due to this selective yet profound defect in the immune system, these patients are prone to recurrent severe opportunistic infections and kaposi's sarcoma. while therapies exist for some of these complications of acquired immunodeficiency syndrome, no effective therapies ...19852990706
aids and haemophilia: morbidity and morality in a well defined population.one hundred and forty-three multitransfused patients with hereditary haemostatic disorders were examined for evidence of disease related to the acquired immune deficiency syndrome (aids). ninety-nine patients with severe haemophilia a were tested for anti-htlv-iii and 76 were found to be positive. all except one of these seropositive patients had received commercial factor viii concentrates at some time. eighteen patients with haemophilia b were tested and all were anti-htlv-iii negative. three ...19852994801
polyclonal b cell hyperplasia associated with epstein-barr virus causing acute renal allograft failure.six weeks post cadaver renal transplantation, a patient developed a flu-like illness. acute renal failure unresponsive to anti-rejection therapy occurred and he died four days later from pneumocystis carinii pneumonia and streptococcus viridans septicemia. autopsy revealed a diffuse polymorphic polyclonal b cell infiltrate occupying most organs, including the allograft. primary epstein-barr virus (ebv) infection was established by 1) rising anti-ebv antibody titres; 2) the demonstration of ebv n ...19852994928
treatment of infections in patients with the acquired immunodeficiency syndrome.the microorganisms that regularly infect patients with the acquired immunodeficiency syndrome (aids) have become well recognized. most take advantage of defects in t-lymphocyte function, but others, such as streptococcus pneumoniae and haemophilus influenzae, take advantage of b-cell defects. still others, such as staphylococcus aureus and shigella species, occur or persist for reasons that are unclear. infections with organisms associated with hospitalization and medical procedures are also see ...19852996410
treatment of infectious complications of acquired immunodeficiency syndrome.the infectious complications of the acquired immunodeficiency syndrome (aids) are discussed, and the conventional and nonconventional therapies used for these infections are reviewed. the infections most commonly encountered in patients with aids are pneumocystis carinii pneumonia (58%), candida esophagitis (31%), toxoplasmosis (21%), cytomegalovirus infections (15%), and herpes-simplex virus infections (12%). pneumocystis carinii pneumonia is the most common life-threatening process in these pa ...19852996829
nonbronchoscopic bronchoalveolar lavage for the diagnosis for pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome.we compared conventional bronchoscopic transbronchial biopsy (tbb) and bronchoalveolar lavage (bal) with non-bronchoscopic bronchoalveolar lavage (nb-bal) in nine patients with acquired immunodeficiency syndrome (aids) and bilateral lung infiltrates. nb-bal was carried out with a control-tipped reusable catheter. in each patient, bronchoscopic procedures were performed in the right lung, followed immediately by nb-bal in the left lung. the specimens obtained by nb-bal confirmed the presence of p ...19852996837
diagnostic yield of bronchoalveolar lavage in pneumonitis occurring after allogeneic bone marrow transplantation.fifty-two bronchoalveolar lavages (bal) were performed in order to investigate 46 episodes of pneumonitis that occurred after allogeneic bone-marrow transplantation. no complications have been attributed to this procedure. a specific etiologic diagnosis was obtained in 24 of 46 episodes (52%) by 26 of 52 bal (50%). cytomegalovirus (cmv), diagnosed by the presence of typical inclusions, was the pathogen most frequently identified by bal (13 of 46 episodes) and was associated with other causes of ...19852998245
[aids fatalities in hamburg (status: february 1985)--legal medicine aspects].the registration of patients with acquired immune deficiency syndrome (aids) and aids deaths is centralized for medical research. a short review of the epidemiological state of aids in hamburg is given (situation as of february 1985), and the autopsy results of seven postmortem examinations are referred to. kaposi's sarcoma was seen in four patients and opportunistic infections in all cases, especially as a result of pneumocystis carinii and cytomegalovirus. due to the constellation of groups wi ...19853000111
[pulmonary lesions following bone marrow graft. study of 35 cases].lung biopsy of 35 patients with interstitial pneumonitis following bone marrow transplantation (bmt) have been studied histologically, ultrastructurally and by immunofluorescence. among infectious diseases, cytomegaloviruses (cmv) are the more frequently found, whereas pneumocystis carinii infections are more frequently found in immunocompromised hosts without bmt. cmv infections are related to severe chronic graft-versus-host disease in allogenic or mismatched bmt. hemorrhagic pulmonary oedema ...19853000398
lung in acquired immune deficiency syndrome: infectious and immunological status assessed by bronchoalveolar lavage.bronchoalveolar lavage (bal) has been performed in 63 patients with acquired immune deficiency syndrome (aids) and 20 patients with chronic generalized lymphadenopathy (cgl) for the diagnosis of lung opportunistic infections and analysis of immune effector cells of the lower respiratory tract. in patients with aids, pneumocystis carinii was found in 63%. cytomegalovirus (cmv) pneumonia was assessed by viral cultures of bal fluid and microscopic examination: cmv was found in 62% and 39% respectiv ...19853000489
isolation and buoyant density of pneumocystis carinii in percoll gradients.a new gradient material, percoll, a collodial suspension of silica particles covered with polyvinylpyrolidon, has been used to isolate pneumocystis carinii from infected rat and human lung tissues. the specific gravity of pneumocystis carinii was shown to be within the range of 1.018-1.062 g/ml with most pneumocysts within 1.033-1.049 g/ml.19853001637
the acquired immunodeficiency syndrome (aids).this article discusses clinical, immunologic, and etiologic considerations in the acquired immunodeficiency syndrome (aids) and the relationship of aids to other immunodeficiency diseases. the outstanding clinical feature of aids is the occurrence of opportunistic infections in individuals with no prior known cause of immunodeficiency. such infections have included pneumocystis carinii, oral thrush from candida albicans, cytomegalovirus, atypical mycobacteria, cryptosporidium, and herpes simpl ...19853155526
[1st case of aids in salzburg. important diagnostic hint by determination of neopterin].this case report describes the first case of aids in salzburg. the patient belonged to the male homosexual risk group. he presented with opportunistic infections: oral candidiasis, bilateral pneumocystis carinii pneumonia and cerebral toxoplasmosis. the diagnosis of aids was corroborated by highly elevated urinary neopterin levels. despite treatment with antibiotics the patient died within 5 weeks due to cardiorespiratory insufficiency.19853157271
legionella infections in cyclosporine-immunosuppressed cardiac transplants.pulmonary infections from bacterial or viral agents, as well as rare infectious agents, such as toxoplasma gondii, aspergillus, and pneumocystis carinii, have been a bane to the clinician in charge of the care of transplant patients. one such opportunistic organism, legionella pneumophila, was responsible for four episodes of infection in three of our patients who survived due to better management of immunosuppression, together with aggressive therapy and early diagnosis of the infectious compli ...198515227024
aids epidemic sparks campaign to encourage condom use.the acquired immune deficiency syndrome (aids) is fueling a campaign that encourages use of the condom to combat the spread of sexually transmitted diseases. condom use is being advocated even when one partner is practicing another form of contraception. the threat of aids has spread beyond the original risk groups -- homosexual and bisexual men, intravenous drug users, and transfusion recipients -- to include heterosexual men and women. researchers from the centers for disease control said a ...198512280299
pneumonia associated with infection with pneumocystis, respiratory syncytial virus, chlamydia, mycoplasma, and cytomegalovirus in children in papua new guinea.paired serum samples were collected from 94 children with pneumonia admitted to goroka hospital, papua new guinea. all but three of the children were aged 1-24 months. only nine children were malnourished, with weight for age less than 70% of the harvard median (three had weight for age less than 60% of the harvard median). pneumocystis carinii antigen was detected in the serum of 23 children. twenty two children had serological evidence of recent infection with respiratory syncytial virus. five ...19863002538
opportunistic infections in patients with aids: clues to the epidemiology of aids and the relative virulence of pathogens.the frequency of nine reactivating or opportunistic infections and kaposi's sarcoma among patients with the acquired immunodeficiency syndrome (aids) was reviewed. the diagnoses of 87 patients reported from the colorado aids registry and 359 others from literature reports were abstracted, and data were placed in one of 11 categories on the basis of the risk group of the patient. pneumocystis carinii infection was significantly commoner among blood or blood-product recipients than among natives o ...19863006206
diagnosis for interstitial lung disease in patients with acquired immunodeficiency syndrome (aids): a prospective comparison of bronchial washing, alveolar lavage, transbronchial lung biopsy, and open-lung biopsy.this study was undertaken to compare prospectively the diagnostic yield of the various bronchoscopic techniques with that of open-lung biopsy for interstitial lung disease in patients with acquired immunodeficiency syndrome (aids). under general anesthesia, 15 patients sequentially underwent bronchial washing, transbronchial lung biopsy, alveolar lavage, and open-lung biopsy in the same segment of lung. of nine patients with pneumocystis carinii, seven were diagnosed by means of the transbronchi ...19863006615
pulmonary disease in children with acquired immune deficiency syndrome and aids-related complex.two major pulmonary diseases were defined on the basis of lung biopsies in 15 children with acquired immune deficiency syndrome (aids) or aids-related complex. pneumocystis carinii pneumonia was observed in eight children, and pulmonary lymphoid hyperplasia in six. one child had nonspecific interstitial pneumonitis. children with p. carinii pneumonia had more severe hypoxemia, with higher alveolar-arterial oxygen gradients, and higher isomorphic elevations of serum lactate dehydrogenase. clinica ...19863007714
[diagnosis and therapy of pneumocystis carinii pneumonia in a patient with aids].the clinical, immunological and histological findings in a patient suffering the acquired immunodeficiency syndrome and pneumocystis carinii pneumonia are discussed. at the time of diagnosis htlv iii antibodies were not demonstrable. treatment with trimethoprim sulfamethoxazole achieved a remission lasting 7 months so far. htlv iii antibodies became demonstrable after 5 months; the markedly decreased helper/suppressor ratio of 0.30 remained unchanged.19863008447
infections in heart-lung transplant recipients.infectious episodes were analyzed in 14 heart-lung transplant recipients who survived more than one week after transplantation. these patients had higher rates of infection than heart transplant recipients at our institution (p less than 0.01) and greater than 90% of all infections were potentially life-threatening. a total of 67% of all infections involved the lung or thoracic cavity as a primary site, and most of the rest were disseminated viral or fungal infections. pneumocystis carinii infec ...19863012834
bronchoalveolar lavage as the exclusive diagnostic modality for pneumocystis carinii pneumonia. a prospective study among patients with acquired immunodeficiency syndrome.pneumocystis carinii pneumonia (pcp) is the most common life-threatening opportunistic infection among patients with the acquired immunodeficiency syndrome (aids). because retrospective studies suggested that bronchoalveolar lavage (bal) compared favorably to lung biopsy in the diagnosis of pcp, we prospectively evaluated the utility of bal in 40 consecutive patients with aids or risk of aids who presented with respiratory complaints. the bal revealed p carinii in 36 of 42 episodes of pneumonia ...19863013511
secondary pulmonary alveolar proteinosis occurring in two patients with acquired immune deficiency syndrome.this report describes two patients with acquired immune deficiency syndrome (aids) in whom respiratory failure and opportunistic infection associated with secondary alveolar proteinosis developed. in one patient, the alveolar proteinosis was apparently secondary to mycobacterium tuberculosis and in the other to pneumocystis carinii and cytomegalovirus infection. both patients died of respiratory failure, and it was suspected that secondary alveolar proteinosis could have been a contributing caus ...19863014876
virologic studies of htlv-iii/lav in pregnancy: case report of a woman with aids.the number of cases of acquired immunodeficiency syndrome (aids) in women is increasing. as of december 30, 1985, 1075 cases in women had been reported to the centers for disease control; 81% of these cases occurred in women of childbearing age (15 to 45 years). the human t-lymphotropic virus type iii/lymphadenopathy-associated virus (htlv-iii/lav) can be transmitted from mothers to their infants. described is a woman with transfusion-acquired aids who was six weeks' pregnant at the time pneumoc ...19863016628
demonstration of spermatozoa in the lung of an aids patient.using the dna-binding fluorochrome, dapi, spermatozoa and pneumocystis carinii were easily demonstrated in postmortem lung sections of an aids patient. the possible practical significance of these findings is discussed.19863018351
spectrum of htlv-iii infection in a hemophilic cohort treated with blood products from a single manufacturer.one hundred fifty-eight hemophilia a, b, and von willebrand disease (vwd) patients treated with clotting factor concentrates from a single manufacturer were tested for antibody to the human t-lymphotropic virus type iii (htlv-iii). antibody was detected in 63% and 40% of those with severe hemophilia a and b, respectively, 12% and 0% of those with mild hemophilia a and b, and two patients with recessive vwd. forty-two antibody-positive and 20 antibody-negative patients were studied for clinical a ...19863020977
pulmonary cytology of the acquired immune deficiency syndrome: an analysis of 36 cases.the infectious pathogens and associated cellular reactions in 75 pulmonary cytological specimens obtained largely by fiberoptic bronchoscopy from 36 patients with the acquired immune deficiency syndrome are described and correlated with the biopsy specimens. an opportunistic pathogen was diagnosed in 33% of cytological preparations. pneumocystis carinii was encountered most frequently; cryptococcus neoformans and cytomegalovirus were also seen. the polymorphonuclear neutrophil was the predominan ...19863021408
pulmonary cytology in patients with the acquired immunodeficiency syndrome (aids).over a 2-yr period, 1982-1984, 181 pulmonary cytology specimens were obtained from 45 patients clinically suspected of having aids in an attempt to identify the various organisms and the cytologic atypias present in pulmonary cells. cytologic correlations with autopsy findings were available for 28 of these cases (62%). specimens were collected from sputum, bronchial washes and brushes, bronchoalveolar lavages, and pleural fluid. of the 181 specimens, 121 (67%) were of diagnostic value. dependin ...19863021409
update: acquired immunodeficiency syndrome--united states.between june 1, 1981, and january 13, 1986, the centers for disease control (cdc) were notified of 16,458 (16,227 adults and 321 children) cases of acquired immunodeficiency syndrome (aids) in the us. of these, 8361 (51% of adults and 59% of the children) have died, including 71% of those diagnosed before july 1984. 90% of adults aids cases were 20-49 years old, and 93% were men. significant changes have occurred over time in the distribution of specific diseases reported. pneumocystis carin ...19863079867
length of survival of patients with acquired immune deficiency syndrome in the united kingdom.an analysis of the lengths of survival of patients with the acquired immune deficiency syndrome presenting with different opportunistic diseases was performed using epidemiological data routinely collected at the phls communicable disease surveillance centre. the overall crude case fatality rate was 55.4% (93/168). the median survival times were: 21.2 months for kaposi's sarcoma, 12.5 months for pneumocystis carinii pneumonia, and 13.3 months for other opportunistic infections. the shortest medi ...19863089373
eflornithine treatment of pneumocystis carinii pneumonia in aids. 19863093697
clinical and bronchoscopic diagnosis of suspected pneumonia related to aids.in a series of 25 patients with suspected pneumonia related to the acquired immune deficiency syndrome (aids) the first 12 underwent routine fibreoptic bronchoscopy and bronchoalveolar lavage with or without transbronchial biopsy before treatment. eight were found to have pneumocystis carinii pneumonia and had typical clinical presentations with a prolonged history of symptoms, including a dry cough, and bilateral diffuse alveolar or interstitial shadowing in chest radiographs. among the subsequ ...19863094663
serum amyloid protein a (saa): an indicator of inflammation in aids and aids-related complex (arc).the acute phase protein serum amyloid a (saa) and c-reactive protein (crp) were measured in a group of 30 homo- and bisexual males with aids, 31 males with aids-related complex (arc) and 23 healthy male homosexual controls (hc) in copenhagen. the mean values of saa and crp were significantly higher in the aids group compared to the two other groups. saa was elevated also in the arc group, whereas the mean crp value was normal. no increase in saa and crp was found in the hc group. the aids patien ...19863095915
remission of diarrhoea due to cryptosporidiosis in an immunodeficient child treated with hyperimmune bovine colostrum.a boy aged 6 months who presented with poor weight gain, diarrhoea, and infection with pneumocystis carinii was found to have congenital hypogammaglobulinaemia, which did not improve despite monthly treatment with intravenous gammaglobulin. at the age of 3 years and 2 months he developed severe vomiting and diarrhoea due to cryptosporidiosis, which failed to respond to conventional treatment. infusion of hyperimmune bovine colostrum produced against parasite antigen, given by nasogastric tube, w ...19863096462
infection and transfusion therapy in acute leukaemia.granulocytopenia is the single most important risk factor for infection in patients with acute leukaemia. there are limitations to the effective prophylaxis of infection in granulocytopenic patients, but practical measures include the management of the patient in a private hospital room, the requirement of all medical personnel and visitors to wash their hands carefully and to wear masks, restricting the patient to a low-bacteria diet devoid of fresh fruit, vegetables and salads, and the adminis ...19863096621
inhibition of polyamine biosynthesis by alpha-difluoromethylornithine in african trypanosomes and pneumocystis carinii as a basis of chemotherapy: biochemical and clinical aspects.the symposium provided dramatic evidence of the value of the use of polyamine inhibition via alpha-difluoromethylornithine (dfmo, eflornithine) for advances in chemotherapy of trypanosoma brucei gambiense sleeping sickness and pneumocystis carinii pneumonia in acquired immune deficiency syndrome (aids) and also for further understanding the metabolic importance of the ubiquitous polyamines in these organisms.19863098121
novel immunofluorescence test for pneumocystis carinii. 19862868278
prospective evaluation of a monoclonal antibody in diagnosis of pneumocystis carinii pneumonia.to evaluate the ability of a mouse monoclonal antibody, 2g2, directed against human pneumocystis carinii, to detect the organism in clinical specimens, a prospective study of the antibody in an indirect immunofluorescent assay was undertaken. p carinii was rapidly detected in thirteen of fourteen bronchoalveolar lavage specimens positive by toluidine-blue-o stain, none of eleven lavage specimens negative by toluidine-blue-o, neither of two impression smears of histologically negative open-lung b ...19862873314
monoclonal antibody to detect pneumocystis carinii. 19862875351
[pneumocystis carinii in the lungs of calves]. 19862938746
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