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kaposi's sarcoma and acquired immunodeficiency syndrome. postmortem findings in twenty-four cases.autopsy results on twenty-four patients with acquired immunodeficiency syndrome (aids) and kaposi's sarcoma were reviewed. at postmortem, 29% of patients had evidence of visceral kaposi's sarcoma without skin lesions. the most common sites for visceral involvement with kaposi's sarcoma were as follows: lung (37%), gastrointestinal tract (50%), and lymph nodes (50%). at the time of death, only 25% of patients had evidence of cutaneous disease alone. the patients survived up to 36 months after the ...19873029191
the effectiveness of bronchoscopy in the diagnosis of pneumocystis carinii and cytomegalovirus pulmonary infections in acquired immunodeficiency syndrome.we evaluated the sensitivity of bronchoscopy for the diagnosis of pneumocystis carinii and cytomegalovirus pulmonary infections in patients with acquired immunodeficiency syndrome. the antemortem and postmortem diagnoses were compared in 36 patients who underwent fiberoptic bronchoscopy within two weeks of death. in autopsy-proved cases of pneumocystis carinii pneumonia (pcp), the organism was correctly identified antemortem in 22 (88%) of 25 cases, including 94% of adequate transbronchial bronc ...19873030223
pneumocystis carinii pneumonia in infants given adrenocorticotropic hormone for infantile spasms. 19873035157
pneumocystis carinii involvement of the bone marrow in acquired immunodeficiency syndrome.a case of pneumocystis carinii involvement of the bone marrow in acquired immunodeficiency syndrome is reported. the literature is reviewed for other cases of known extrapulmonary dissemination of pneumocystis. potential mechanisms of dissemination of pneumocystis and its clinical implications are discussed.19873035916
opportunistic infections in the acquired immune deficiency syndrome.the acquired immune deficiency syndrome (aids) results in a t lymphocyte deficiency and, consequently, a susceptibility to opportunistic infections with organisms that previously were better known as causes of disease in patients with hodgkin's disease or recipients of immunosuppressive therapy. pneumocystis carinii, candida albicans, and cytomegalovirus (cmv) are among the most frequently observed pathogens in aids patients, followed by atypical mycobacteria, toxoplasma gondii, mycobacterium tu ...19873037706
pneumocystis carinii pneumonia following heart transplantation.pneumocystis carinii pneumonia represents a rare complication that is associated with a high mortality following heart transplantation. the cases of two heart transplant recipients who developed pneumocystis pneumonia within the first 3 postoperative months are reported. both patients had severe clinical symptoms of the disease; the diagnosis was confirmed by bronchoalveolar lavage, and the patients were treated with a combination of trimethoprim and sulfamethoxazole. both patients recovered and ...19873273214
value of repeat fiberoptic bronchoscopies and significance of nondiagnostic bronchoscopic results in patients with the acquired immunodeficiency syndrome.out of 286 patients with the acquired immunodeficiency syndrome (aids) who had fiberoptic bronchoscopies performed for the diagnosis of pulmonary disease, 21 (7.3%) patients (group i) had repeat procedures after 1 to 30 days (mean, 14.8 days) because of persistent pulmonary infiltrates despite therapy, and 46 (15.9%) patients (group ii) had repeat procedures after 2 to 32 months (mean, 7.5 months) because of recurrent pulmonary infiltrates after initial clinical and radiographic improvement. pne ...19873813206
nonbronchoscopic lung lavage for diagnosis of opportunistic infection in aids.thirty patients known to have or suspected of having acquired immunodeficiency syndrome (aids) were evaluated for opportunistic pulmonary infection using a double lumen lavage catheter (dll). lavage specimens obtained were cytocentrifuged and initially stained by the papanicolaou technique as a means of rapid evaluation for pneumocystis carinii. if no opportunistic organism was identified, the patient underwent further diagnostic investigations. in 18 patients receiving mechanical ventilatory su ...19873816309
the spectrum of pneumonia in 1983 at the riyadh armed forces hospital.the agents causing pneumonia have been assessed in 112 adult patients admitted to the armed forces hospital in riyadh during a period of one year: pathogens were identified in 78 patients (69.6%). sputum culture produced a significant isolate in 60 patients (53.5%), and in 17 (15.2%) the causative agent was suggested by serological tests. streptococcus pneumonia was the commonest infecting agent (21.4%). pneumonia due to mycobacterium tuberculosis was diagnosed in eight patients, to mycoplasma p ...19873819456
role of bronchoalveolar lavage in the assessment of opportunistic pulmonary infections: utility and complications.we prospectively evaluated the diagnostic role of bronchoalveolar lavage in the assessment of opportunistic pulmonary infections and the incidence of associated complications in 100 immunocompromised patients during a 9-month period. bronchoalveolar lavage was useful in detecting the presence of pneumocystis carinii, viruses, fungi, bacteria, and mycobacteria in the lower respiratory tract. p. carinii was diagnosed by bronchoalveolar lavage in 17 patients and by open-lung biopsy in 1. other orga ...19873586713
children with aids--is pathologic diagnosis possible based on chest radiographs?in a review of the clinical, radiographic and pathologic data of 36 patients with aids we found 29 with pulmonary infections (cytomegalic virus, pneumocystis carinii, etc.) and 7 who had varying types of lymphocytic infiltration and interstitial changes on chest radiographs but did not have opportunistic infection. pathologic diagnosis included lymphocytic interstitial pneumonitis, bronchus associated lymphoid tissue, chronic interstitial pneumonitis, desquamative interstitial pneumonitis and im ...19873601462
psychosocial considerations in the therapy of epidemic kaposi's sarcoma.since the acquired immune deficiency syndrome (aids) burst into prominence in 1981, it has claimed victims at an exponential rate and taxed the resources of physicians, health workers, and social support agencies. a sizeable minority of aids patients, mainly male homosexuals, have been presented with epidemic kaposi's sarcoma (eks). although life expectancy with this presentation may be greater than with pneumocystis carinii pneumonia or other opportunistic infection, the underlying immunodefici ...19873603057
[disseminated mucocutaneous kaposi sarcoma in aids. clinical and therapeutic experiences in 13 patients].since 1980 a new epidemic form of disseminated mucocutaneous kaposi's sarcoma (ks) with a progressive clinical course has been observed in populations at risk. since 1982, 13 cases of aids-associated ks have been seen in our department; all of them were in young homosexual males with circulating hiv antibodies and a reduction in the ratio of t-helper to t-suppressor lymphocytes (0.05-1.3). following systemic treatment with recombinant alpha a-interferon (rifn-alpha a) over a period of 6 months ( ...19873610636
pneumonias acquired from others. 1. history, examination, laboratory findings.differential diagnosis of community-acquired pneumonia can be elusive, even though the disease remains a frequent cause of admission to the hospital. the familiar organisms--pneumococci, group a streptococci, staphylococcus aureus, klebsiella pneumoniae, and hemophilus influenzae--are still often the cause. however, less common organisms, in particular pneumocystis carinii, which is associated with acquired immunodeficiency syndrome, are being seen more often. data gathered from a thorough histo ...19873615308
a high performance liquid chromatography method for trimethoprim utilizing solid-phase column extraction.the antibiotic combination of sulfamethoxazole and trimethoprim was evaluated for treatment of peritonitis in patients in renal failure undergoing continuous ambulatory peritoneal dialysis. although current methods of analysis were adequate for measurement of sulfamethoxazole, a review of the available methods of analysis for trimethoprim did not yield a satisfactory method. therefore, a high performance liquid chromatography (hplc) assay was developed to follow the pharmacokinetics of trimethop ...19873617162
acquired immune deficiency syndrome (aids) in brazil. necropsy findings.according to the 15 autopsies performed at the department of pathological anatomy, escola paulista de medicina, são paulo, brazil, it was confirmed that acquired immunodeficiency syndrome (aids) occurs preferably in young homosexual males, who die in a short period of time of the disease, which leads to a consumptive state verified by cachexia of the cadavers. the most affected organs of this series were the lungs and encephalum, exactly the ones responsible for the immediate cause of death. in ...19873620018
autopsy findings in aids--a histopathological analysis of fifty cases.fifty consecutive aids autopsy cases were evaluated. all subjects showed one or more opportunistic infections and malignancies included in the aids case definition with cytomegalovirus and kaposi's sarcoma being most prevalent. mycobacterial and cryptococcal infections occurred only infrequently. most patients of our series after successful treatment of pneumocystis carinii pneumonia or cerebral toxoplasmosis later succumbed to less treatable conditions like disseminated cytomegalovirus or funga ...19873626432
fatal infections in systemic lupus erythematosus: the role of opportunistic organisms.the causes of death were examined in patients with systemic lupus erythematosus (sle) who were cared for at the university of california, san francisco and who died after 1969. of the 44 deaths analyzed, 33 patients had autopsies. infections were common and often determined to be the cause of death. overall, infections were present in 55 percent (22/44), and judged to be a cause of death in 30 percent (13/44) of all deaths. the infections could be divided into 2 groups: those due to common bacte ...19873626846
successful treatment with aerosolized pentamidine of pneumocystis carinii pneumonia in rats.we examined both the therapeutic efficacy and tissue distribution of aerosolized pentamidine in immunosuppressed rats with pneumocystis carinii pneumonia. in rats immunosuppressed by 5 weeks of pretreatment with dexamethasone, a 2-week course of 5 mg of aerosolized pentamidine per kg per day, administered free or encapsulated in the drug carrier system (liposomes), eradicated p. carinii pneumonia in 75% of treated animals. at this dose, extrapulmonary drug uptake as measured by a sensitive high- ...19873494424
comparison of histologic and quantitative techniques in evaluation of therapy for experimental pneumocystis carinii pneumonia.pneumocystis carinii pneumonia was induced in rats by the administration of corticosteroids, and histologic and quantitative techniques were compared in the evaluation of the severity of the disease and response to therapy. a highly significant correlation was found between the histologic score of the extent of alveolar involvement (the standard method of assessment) and the number of p. carinii cysts and nuclei in lung homogenates, lung weight, and lung weight/body weight ratio. clear differenc ...19873494426
disseminated pneumocystis carinii infection in aids. 19873494947
pneumocystis carinii pneumonitis, eosinophilia and hypogammaglobulinemia. 19873494981
freeze-fracture studies on pneumocystis carinii. ii. fine structure of the trophozoite.ultrastructure of the trophozoite of pneumocystis carinii was studied by the freeze-fracture technique. nuclei and cytoplasmic organelles such as the endoplasmic reticulum, mitochondria, cytoplasmic vacuoles and small round bodies were observed. the mean number of nuclear pores was 8 per micron 2, which is small compared with that reported for other human pathogenic protozoa. in general, the density of nuclear pores is considered to be related to the metabolic activity of the nucleus. this resul ...19873494990
atypical distribution of pneumocystis carinii infiltrates during radiation therapy.bilateral peripheral pulmonary infiltrates caused by pneumocystis carinii developed in a patient undergoing mediastinal irradiation after chemotherapy for hodgkin disease. the paramediastinal part of the lung included within the treatment port remained clear during the 2 1/2 weeks of radiation therapy. the distribution of the pneumocystis infiltrates was altered by the radiation, producing a pattern that is the "radiographic negative" of typical post-radiation therapy paramediastinal fibrosis.19873495020
pneumocystis carinii pneumonia. 19873495178
drug treatment of pneumonia due to pneumocystis carinii. 19873493548
pneumocystis carinii. taxonomy as viewed by electron microscopy.pneumocystis carinii is an opportunistic unicellular organism that can cause serious pulmonary infection in immunosuppressed patients. the taxonomy and classification of p. carinii has not yet been settled. the authors present transmission and scanning electron microscopic (tem and sem) observations of tissue from two patients with pulmonary pneumocystis infections. the infectious organisms display marked variability in shape and size. they appear to divide by binary fission and lack motility or ...19873493682
unusual remission of pneumocystis carinii pneumonia in a patient with the acquired immune deficiency syndrome.pneumocystis carinii is a well-recognized cause of pneumonia in patients with immune deficiency, and when untreated, mortality approaches 100 percent. although rare cases suggesting spontaneous recovery (usually accompanied by resolving immune deficiency) have been reported, spontaneous resolution of p. carinii pneumonia in patients with the acquired immune deficiency syndrome (aids) has not been described. a patient with aids in whom pneumocystis pneumonia developed and remitted without appropr ...19873493693
serological study of pneumocystis carinii infection in the absence of immunosuppression.serum samples from 145 children with no known immunosuppressive illness were examined by indirect immunofluorescence for antibody to pneumocystis carinii. positive antibody titres (greater than or equal to 1:8 dilution) were found in 69 children (48%). antibody could not be detected in the remaining children. previous studies have shown that at least 75% of children have antibodies to p. carinii by the age of 4 years. this study shows a lower percentage of children with detectable antibody. this ...19873493735
evidence for destruction of lung tissues during pneumocystis carinii infection.five cases of pneumocystis carinii infection with evidence of lung tissue destruction that occurred in patients with the acquired immunodeficiency syndrome were reviewed. none of the patients had a history of cigarette smoking, but all five had either cavitarylike lesions in the lungs or had pneumothorax at the time of presentation to the hospital. all patients had p carinii identified in specimens obtained either from bronchial washings or from open-lung biopsy. in four of the five patients, no ...19873493747
defect in production of b cell differentiation factor-like activity by mononuclear cells from a boy with hypogammaglobulinemia.the case history of a boy who presented at 6 mo of age with pneumocystis carinii pneumonia is described. hypogammaglobulinemia was detected. his t lymphocytes and b lymphocytes proliferated with mitogens but no immunoglobulin was secreted secondary to polyclonal stimulation with pokeweed mitogen. his peripheral blood mononuclear cells secreted interleukin 2 and b cell growth factor (bcgf) but failed to secrete detectable levels of b cell differentiation factor (bcdf). studies of his b lymphocyte ...19873494068
pneumocystis carinii choroiditis in a male homosexual with aids and disseminated pulmonary and extrapulmonary p. carinii infection. 19873494199
[pneumocystis carinii pneumonia in patients with aids]. 19873494202
pneumocystis carinii pneumonia in johannesburg.pneumocystis carinii pneumonia is today an opportunistic infection of major importance, occurring in immunosuppressed patients. twelve cases of p. carinii pneumonia were seen by the pulmonology unit in johannesburg between november 1984 and december 1985. the clinical presentation, laboratory and radiographic features, method of diagnosis, treatment, complications of therapy and outcome of these 12 cases are described.19873494316
infectious complications in heart transplant recipients receiving cyclosporine and corticosteroids.the rate of infectious complications differed significantly in two groups of heart transplant recipients who received different immunosuppressive regimens. compared with patients who received conventional immunosuppression, patients treated with cyclosporine had a lower rate of infectious complications, and the contribution of infection to observed mortality was lower. herpes simplex virus caused less morbidity and there were fewer active cytomegalovirus infections in seropositive recipients tre ...19873541723
histoenzymological study of selected dehydrogenase enzymes in pneumocystis carinii.the metabolic activity of pneumocystis carinii cysts was studied histochemically by a tetrazolium dye technique to assess substrate-specific dehydrogenase activity. lactate dehydrogenase, succinate dehydrogenase, and glutamate dehydrogenase produced moderate-to-strong reactions in the cysts, whereas glucose-6-phosphate dehydrogenase had little if any reactivity. these results suggest that pneumocystis cysts have some of the enzymes necessary for glycolysis, krebs cycle activity, and intermediary ...19873546138
patterns of antibody response in individuals infected with the human immunodeficiency virus.immunofluorescence and immunoblot assays were conducted on 488 sera from patients with aids and clinically healthy individuals at risk for infection by the human immunodeficiency virus. of these, 360 contained antiviral antibodies, and nearly all reacted with the envelope precursor glycoprotein gp160. sera from 103 individuals for whom a complete clinical history was available were evaluated in detail. most sera recognized both the gp160 and the p55 gag precursor protein. because these two antig ...19873546516
a comparison of the antigenic characteristics of rat and human pneumocystis carinii by immunoblotting.the antigenic characteristics of rat pneumocystis carinii obtained from infected lungs and grown in tissue culture were compared with the properties of human p. carinii obtained from the lungs of aids and non-aids patients by the immunoblotting technique, using different sources of antibody. major immunoreactive bands of 45, 50, and 116 kd were found in both lung and tissue culture-derived rat p. carinii, suggesting the organism retains its antigenic characteristics in short-term culture. the pr ...19873549900
pneumocystis carinii pneumonia.pneumocystis carinii pneumonia (pcp) has become one of the most important of the opportunistic pulmonary infections of the 1980s. in view of the rapidly expanding population of immunosuppressed patients, many more cases of pcp may be expected in the future. the history, microbiology, pathogenesis, pathology, clinical and laboratory features, diagnosis, treatment, course and prognosis of this disease are reviewed.19873551122
accelerated solute clearance in pneumocystis carinii pneumonia.a radioaerosol clearance test was used to detect lung injury in 12 patients with acquired immune deficiency syndrome (aids) and pneumocystis carinii pneumonia documented by bronchoscopy. the clearance of 99mtc-dtpa was elevated over most regions of interest in all of these patients. in each of 7 subjects who responded to trimethoprim-sulfamethoxazole therapy, clearance returned toward normal. average clearances were either normal or very slightly above the 95% expected upper limit of normal in e ...19873551706
use of pyrimethamine-sulfadoxine (fansidar) in prophylaxis against chloroquine-resistant plasmodium falciparum and pneumocystis carinii.the widespread emergence of chloroquine-resistant plasmodium falciparum led to the formulation of an effective, fixed combination of two antimalarial agents, pyrimethamine and the long-acting sulfonamide sulfadoxine, for prophylaxis and treatment. these drugs act at sequential steps to inhibit the formation of tetrahydrofolate in the parasite. recently, their use for malaria prophylaxis has been associated with severe, at times fatal, cutaneous reactions including erythema multiforme, stevens-jo ...19873551713
pentamidine isethionate. a review of its antiprotozoal activity, pharmacokinetic properties and therapeutic use in pneumocystis carinii pneumonia.pentamidine isethionate, an aromatic diamidine, is an antiprotozoal agent proven to decrease mortality from pneumocystis carinii pneumonia in debilitated infants and immunodeficient adults and children. like the combination antimicrobial agent co-trimoxazole, pentamidine has been shown in retrospective studies to resolve episodes of pneumonia in approximately 41 to 87% of patients, including those with the acquired immunodeficiency syndrome (aids), when used alone or as sequential therapy. altho ...19873552596
use of trimethoprim-sulfamethoxazole in pediatric infections: relative merits of intravenous administration.trimethoprim-sulfamethoxazole (tmp-smz) has traditionally been employed as an oral formulation for infections in ambulatory pediatric patients. however, therapeutic concentrations of tmp and smz in serum and csf are more consistently attained after intravenous administration. serum half-life increases with the age of the child, and few significant toxic effects are observed with intravenous administration. either the necessity to optimize bioavailability because of the underlying seriousness of ...19873554455
use of trimethoprim-sulfamethoxazole singly and in combination with other antibiotics in immunocompromised patients.experience with trimethoprim-sulfamethoxazole (tmp-smz) alone or in combination with other agents in the treatment of immunocompromised patients other than those with pneumocystis carinii pneumonitis and the acquired immunodeficiency syndrome is reviewed. a comparative study involving 126 episodes of fever showed a higher rate of response to a tmp-smz-carbenicillin regimen than to a gentamicin-carbenicillin combination (85% vs. 69%, respectively, p less than or equal to .04). in another study tm ...19873554456
use of trimethoprim-sulfamethoxazole in the treatment of pneumocystis carinii pneumonitis in patients with acquired immunodeficiency syndrome.this report reviews the use of trimethoprim-sulfamethoxazole (tmp-smz) in individuals with pneumocystis carinii pneumonitis (pcp) and the acquired immunodeficiency syndrome (aids). before aids, tmp-smz was at least as effective as pentamidine in pediatric and adult populations and was notably less toxic. in a study prospectively comparing tmp-smz with pentamidine in patients with aids, the toxicity associated with either therapy was very high, a problem suggesting a need for the development of a ...19873554457
pneumocystis carinii: immunoblotting and immunofluorescent analyses of serum antibodies during experimental rat infection and recovery.serum antibodies to pneumocystis carinii were measured in rats by the indirect fluorescent antibody and immunoblotting techniques. serum igg and igm antibodies developed with environmental exposure to p. carinii, were low or absent during immunosuppression to induce p. carinii pneumonia, and rose when immunosuppression was withdrawn. the igg and igm antibodies formed at the same time, but the titers of each antibody varied in individual rats. serum igg antibodies by immunoblotting recognized ban ...19873556208
[kaposi's disease in aids: 31 cases].we report 31 cases of aids-kaposi's sarcoma (ks) studied at the hôpital saint-louis, paris, france, from january 1983 to january 1986. twenty-nine cases were cutaneous ks and 2 were lymph-node ks. twenty-eight patients were homosexual or bisexual males, 1 was a woman with transfusion-aids and 1 was an intravenous drug-addict; one male had no known risk factor. thirty were male and 1 female, mean age 35.5 years (+/- 8.4). all were caucasian and positive for lav antibodies (elavia). 17/30 (56.6 p. ...19873579136
diagnosing pneumocystis carinii. 19872433100
activity of antifolates against pneumocystis carinii dihydrofolate reductase and identification of a potent new agent.the therapy of pneumocystis carinii (pc) pneumonia is often unsuccessful, particularly in patients with acquired immune deficiency syndrome (aids). because of difficulties in growing the organism in vitro or obtaining purified organisms, current treatment choices have been made with little information on the metabolic effects of therapeutic agents on pc. this report quantitates the effects of the commonly used antifolates as well as the classic antineoplastic antifolate methotrexate and a lipid- ...19872950200
improved rat model for studying pneumocystis carinii pneumonia.sprague-dawley rats treated for 8 weeks with cortisone acetate (25 mg per rat twice weekly) were immunosuppressed to variable degrees. a total of 55% lost over 12% of their initial body weight, had cortisol concentrations in serum more than five times greater than those of the controls, and had markedly depressed ratios of helper to non-helper t cells, in both the spleen and peripheral blood. animals that gained weight during immunosuppression had cortisol concentrations in serum only three time ...19872952669
evidence for depressed humoral immunity to pneumocystis carinii in homosexual males, commercial plasma donors, and patients with acquired immunodeficiency syndrome.heterosexual controls were found to have significantly higher titers of immunoglobulin g antibody to pneumocystis carinii than did patients with the acquired immunodeficiency syndrome (aids) and p. carinii pneumonitis, human immunodeficiency virus (hiv) antibody-positive or -negative homosexual male "gay bar" patrons, and hiv antibody-positive or -negative commercial plasma donors. the t-helper/t-suppressor lymphocyte ratios of hiv antibody-negative homosexual male gay bar patrons were slightly ...19872954997
sources of rats free of latent pneumocystis carinii.two sources of rats free of latent pneumocystis carinii are described. first, rats from a virus-free colony failed to develop infection after 8 weeks of immune suppression unless they were housed with previously infected rats. second, pregnant rats (non-virus free) received trimethoprim-sulfamethoxazole from day 10 of gestation until the pups were weaned. pups raised in filter-topped cages and immunosuppressed for 8 weeks were free of p. carinii infection.19872958497
pneumocystis carinii pneumonitis. 19872958709
trimetrexate for the treatment of pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome.preclinical studies have demonstrated that trimetrexate is a potent inhibitor of dihydrofolate reductase from pneumocystis carinii. on the basis of this evidence, this lipid-soluble antifolate was used as an antipneumocystis agent in 49 patients with the acquired immunodeficiency syndrome (aids) and pneumocystis pneumonia. simultaneous treatment with the reduced folate leucovorin was used as a specific antidote to protect host tissues from the toxic effects of the antifolate without affecting th ...19872958710
treatment of pneumocystis carinii pneumonia. 19872959845
pneumocystis carinii pneumonia: a lethal complication of "pulse" methylprednisolone therapy.a previously healthy, hiv-negative, 67-year-old man developed rapidly progressive glomerulonephritis. following "pulse" methylprednisolone therapy he developed pneumocystis carinii pneumonia. this complication should be recognized as a potential hazard of "pulse" steroid therapy.19872960621
pneumocystis carinii pneumonitis in adults with acute lymphoblastic leukaemia. 19872882273
corticosteroids as adjunctive therapy in treatment of pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome.10 patients with the acquired immunodeficiency syndrome whose respiratory failure due to pneumocystis carinii pneumonia (pcp) was deteriorating rapidly had 7 days of intravenous methylprednisolone added to their antibiotic regimen. 8 similar patients were treated with antibiotic therapy alone. 9 of the 10 methylprednisolone-treated patients survived their episode of pcp, compared with 2 of the 8 conventionally treated patients. clinical improvement was evident within 2 days of the start of stero ...19872885462
aerosolised pentamidine as sole therapy for pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome.15 patients with first episodes of pneumocystis carinii pneumonia and the acquired immunodeficiency syndrome were treated with only aerosolised pentamidine, which they inhaled for 20 minutes every day for 21 days. 13 of the 15 responded to therapy. mean pao2 (mm hg) and vital capacity (% predicted) were 67.9 and 50.8 before therapy and 80.1 and 67.9 after therapy in patients successfully treated. no systemic side-effects occurred and serum pentamidine concentrations were low in all patients. the ...19872887779
treatment for pneumocystis carinii infection in leukaemia. 19872887822
role for steroids in treatment of pneumocystis carinii pneumonia in aids. 19872887824
modified trimethoprim-sulphamethoxazole doses in pneumocystis carinii pneumonia. 19872889058
steroids and pneumocystis carinii pneumonia. 19872889889
pneumocystis carinii in bronchoalveolar lavage. 19872435764
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
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
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
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
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
possible confusion of aspergillus fumigatus and pneumocystis carinii. 19872449349
pulmonary function following varicella-zoster pneumonia in children with leukemia.varicella-zoster virus (vzv) is a cause of serious pneumonias in immunosuppressed patients. although there are reports of residual lung changes in adults following vzv pneumonia, no previous studies of lung function in children following this infection have been done. we studied 11 patients (median age 11 years) who had had vzv pneumonia 1 to 16 years previously. all patients had a primary diagnosis of acute lymphocytic leukemia. pneumonia was mild in most of the patients: three had only radiogr ...19872821472
cytopathology of opportunistic infection in bronchoalveolar lavage.bronchoalveolar lavage is an important tool for the cytologic and microbiologic examination of the lung. silver- or papanicolaou-stained slides from 604 lavage specimens from 344 patients were evaluated for the presence of fungal, parasitic, and viral organisms. yeast, pseudohyphae, or hyphae occurred in 155 specimens (25.7%). candida was the most frequent opportunistic fungus in immunosuppressed hosts. patients with clinically significant candida infection had many budding yeasts and pseudohyph ...19872821792
cytomegalovirus infection in pregnancy.cytomegalovirus (cmv) is the most common agent of prenatal (peri- and early postnatal) infection of the newborn with an incidence of 0.2-2.0% (5-10%) depending on the socio-economic status. only one out of 20 congenitally cmv-infected newborns shows serious symptoms. another two may reveal mental retardation and other significant handicaps in later age. perinatal cmv infection occasionally causes atypical pneumonia, mostly combined with pneumocystis carinii infections similar to reports of aids ...19872822748
pneumonia in the immunocompromised child.certain types and causes of pneumonia are unique to the immunocompromised host. the most frequent causes are cytomegalovirus, pneumocystis carinii, varicella zoster virus, candida species and aspergillus species. lymphoid interstitial pneumonia has recently been recognized in children with the acquired immunodeficiency syndrome. with the exception of varicella-zoster pneumonitis, an invasive procedure, such as open lung biopsy, is required to establish a definitive diagnosis. infrequent causes o ...19872825316
value of bronchoalveolar lavage in the management of severe acute pneumonia and interstitial pneumonitis in the immunocompromised child.the diagnostic value of 73 bronchoalveolar lavages was assessed in 67 immunocompromised children (aged 3 months to 16 years) with pulmonary infiltrates. thirty one children had primary and 19 secondary immune deficiency, 14 acquired immunodeficiency syndrome (aids), and three aids related complex. bronchoalveolar lavage was performed during fibreoptic bronchoscopy, under local anaesthesia in all but two. one or more infective agents was found in eight of 11 patients with severe acute pneumonia a ...19872827334
feline leukemia virus and pneumocystis carinii infection. 19872830393
intestinal cryptosporidiosis. association with pneumocystis carinii, cytomegalovirus and candida sp. infections. 19872841748
co-trimoxazole red cell aplasia in leukaemia.a 4 year old boy with acute lymphoblastic leukaemia developed a pure red cell aplasia 13 months after entering remission and while on maintenance chemotherapy. co-trimoxazole was also being administered for prophylaxis against pneumocystis carinii infection. when co-trimoxazole was stopped the red cell aplasia resolved.19873101617
hiv infection and aids in newborn babies of mothers positive for hiv antibody.2/3 of the reported cases of the acquired immune deficiency syndrome (aids) in children have no risk factor except a mother belonging to a group with an increased prevalence of infection with human immunodeficiency virus (hiv). there is evidence of transplacental passage of the virus during early and late gestation, but the incidence of fetal and neonatal infection in newborn babies of seropositive mothers has not yet been determined. this article presents the clinical and serological outcome ...19873103824
from persistent generalised lymphadenopathy to aids: who will progress?the current rate of progression of persistent generalized lymphadenopathy to acquired immunodeficiency syndrome (aids) was tested in a cohort of 105 homosexual men in london, uk. 5 patients were lost to follow-up, and the remaining 100 were seen every 3 months. all tested positive for the human immunodeficiency virus antibody. previous clinical observations had shown oral candida; anemia; leucopenia; thrombocytopenia; enthrocyte sedimentation rate 15 mm in the 1st hour to be possible predicto ...19873105780
[experimental infection with pneumocystis carinii in mice]. 19873109709
postoperative enteral hyperalimentation for cryptosporidial acute cholecystitis associated with aids and enteritis.a homosexual youth presented with undiagnosed acute cryptosporidial cholecystitis, a fever of 102.8 degrees f and a wbc of 3500/mm3. this was preceded by several months of watery diarrhea and 20% weight loss. following cholecystectomy, g-i function was maintained by efficient esophageal aspiration of swallowed air, with simultaneous immediate duodenal feeding of elemental diet. he absorbed 160 g amino acids and 4200 kcal, and was safely self-sufficient when discharged 26 hours postoperatively. r ...19873112208
co-trimoxazole treatment of two fatal cases of pneumocystis carinii pneumonia--changes in protozoan morphology and treatment method. 19873112273
[effect of long-term preventive use of tmps on the composition and resistance behavior of aerobic fecal flora].trimethoprim sulfa is a valuable agent in the prophylaxis of pneumocystis carinii pneumonia in immunocompromised children. like several other antimicrobial substances also tmps has an impact on the normal bacterial flora of children. tmps sensitive enterobacteria are eliminated from the gut flora within 48 hours. the impact on the total number of aerobic organisms and the composition of the fecal flora however is just moderate. major changes in gut flora result from previous administration of an ...19873112699
review of death certificates to assess completeness of aids case reporting.to assess the level of reporting of acquired immunodeficiency syndrome (aids) cases, the authors reviewed death certificates for periods of 3 months during july through december 1985 in each of four cities: washington, dc, new york city, boston, and chicago. since reporting began in 1981, these cities have reported 38 percent of all aids cases in the united states. death certificates were selected and matched to the aids surveillance registries in each city, and medical records of those not on t ...19873112848
early predictors of in-hospital mortality for pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome.one hundred forty-five patients were initially seen with pneumocystis carinii pneumonia (pcp). of the many features examined, several variables were identified early in the hospitalization for pcp that were associated with poor survival. these included multiple admissions, leukocytoses, elevated serum lactate dehydrogenase levels, decreased arterial oxygen pressure (tension), decreased arterial carbon dioxide pressure (tension), and decreased serum albumin levels. variables that were associated ...19873115209
surveillance of aids in the united kingdom.the surveillance of cases of the acquired immune deficiency syndrome (aids) in the united kingdom is described and a preliminary analysis made of the 1012 cases that were reported to the end of august 1987. homosexuals were the largest risk group. for the first time it is possible to present cases by the date of diagnosis and by the regional health authority of residence. the rate of increase of new cases shows no sign of slowing down. one third of patients with aids lived in a different regiona ...19873121064
detection of surface carbohydrates on pneumocystis carinii by fluorescein-conjugated lectins.lectins react with a wide range of different carbohydrates (table 1). even so-called monospecific anti-h(o) lectins from lotus tetragonolobus, ulex europaeus, and anguilla anguilla react not only with the anti-h determinant but also with several fucosylated carbohydrates. consequently, the type of lectin receptor existing on the surface of pneumocystis carinii should be determined, because only a carbohydrate analysis can demonstrate the kind of carbohydrates which exist on the cell surface of t ...19873125541
infant pneumonitis associated with cytomegalovirus, chlamydia, pneumocystis, and ureaplasma: follow-up.a total of 205 infants who were hospitalized when younger than 3 months of age for pneumonitis were followed longitudinally. of these patients, 145 (70%) had evidence of infection with one or more pathogens. the most common etiologic agents were chlamydia trachomatis 61/193 (36%), respiratory syncytial virus 33/142 (23%), cytomegalovirus 42/203 (20%), pneumocystis carinii 30/171 (17%), and ureaplasma urealyticum 21/125 (16%). the initial clinical presentation was characterized by cough, rales, n ...19873025807
aids and africa.this article describes the aids situation in africa and pinpoints the differences, so far as they are known, between that continent and the us and europe. there is currently evidence of infection in up to 15% of the general urban population of some african countries, although it is impossible to estimate the total number of cases. among san francisco homosexuals who are sero-positive, about 1/3 are expected to develop aids within 5 years; among infected newborns the development of aids is even ...198712340978
treatment and prophylaxis for pneumocystis carinii pneumonia.without treatment, pneumocystis carinii pneumonitis is almost always fatal in the immunocompromised host. here, walter hughes discusses proven and potential treatments, and methods of chemoprophylaxis in high-risk patients. two drugs, pentamidine isethionate and trimethoprimsulfamethoxazole, are equally effective therapeutically - permitting the recovery of approximately 75% of patients - but the latter drug combination is preferred because of its lower toxicity and fewer adverse effects. the pn ...198715462879
prophylaxis of infection in bone marrow transplants.bone marrow transplants experience severe immuno-deficiency as a consequence of pretransplant radiation and chemotherapy, transient granulocytopenia before marrow engraftment, and post-transplant prevention and treatment of graft-versus-host disease with immuno-suppressive agents. during periods of granulocytopenia, chemoprophylaxis with the oral fluorinated quinolones can prevent colonization and infection with gram-negative bacilli, is better tolerated than oral non-absorbable antibiotics or t ...19883127217
the role of the fda in the effort against aids.the food and drug administration has instituted several pro-active measures to expedite the review of treatments, diagnostics, and vaccines for aids and related conditions. in particular, the agency has established a special designation--1-aa--for a potential aids product which gives top priority to its review. this special expedited review process for aids products has provided for greater cooperation between their sponsors and fda's reviewers. aids products also receive prompt consideration fo ...19883131814
pneumocystis carinii pneumonia presenting as cavitary lung disease. 19883133605
cationic antitrypanosomal and other antimicrobial agents in the therapy of experimental pneumocystis carinii pneumonia.cationic compounds used in the treatment of veterinary african trypanosomiasis have structural properties similar to those of pentamidine, which has been used in the therapy of human trypanosomiasis and infection with pneumocystis carinii. we have compared the activities of these drugs and other antimicrobial agents in an immunosuppressed rat model of p. carinii pneumonia. diminazene, imidocarb, amicarbalide, quinapyramine, and isometamidium showed efficacy greater than or equal to that of penta ...19883137861
treatment of pneumocystis carinii pneumonia in patients with aids.a 44-year-old man with acquired immunodeficiency syndrome (aids) and pneumocystis carinii pneumonia (pcp) who suffered adverse effects from treatment with trimethoprim-sulfamethoxazole (tmp-smx) and was then treated with pentamidine isethionate is described, and approved and investigational drugs used in the management of pcp in the aids patient are discussed. after taking tmp-smx, 240 mg trimethoprim and 1200 mg sulfamethoxazole, four times a day orally for 10 days at home, the patient was hosp ...19883138063
[treatment of pneumocystis carinii pneumonia (pcp) with trimethoprim-sulfamethoxazole and pentamidine in human immunodeficiency virus (hiv) infected patients--a case study and review of literature]. 19883138328
pneumocystis carinii pneumonia. 19883140952
efficacy of dl-alpha-difluoromethylornithine in a rat model of pneumocystis carinii pneumonia.pneumocystis carinii pneumonia is often the terminal event for patients with the acquired immunodeficiency syndrome. eflornithine (dl-alpha-difluoromethylornithine [dfmo]; ornidyl; merrell dow research institute, cincinnati, ohio) has been used successfully against this protozoan disease in limited clinical trials, although not all patients respond to therapy. in contrast, results of the only reported experiments with dfmo in an animal model were negative. we retested dfmo against p. carinii in ...19883142346
sputum examination in the diagnosis of pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome.to examine the role of sputum examination in the diagnosis of pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome (aids), we conducted a prospective study of 30 patients with aids or suspected aids. sputum was obtained just prior to bronchoscopy by spontaneous cough (20 patients) or by induction with a saline nebulizer (ten patients). pneumocystis carinii was diagnosed by bronchoalveolar lavage in 13 of the 30 patients; two of these patients had p carinii organ ...19883142440
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