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alterations in cysteine proteinase content of rat lung associated with development of pneumocystis carinii infection.the rate of hydrolysis of three cysteine-type proteinase substrates, n-benzyloxycarbonyl-arg-arg-4-methyl-7-coumarylamide (amc) (cathepsin b), arg-amc (cathepsin h), and n-benzyloxycarbonyl-phe-arg-amc (cathepsin l), were determined in rat lung throughout the time course of the induction of pneumocystis carinii infection by immunosuppression. cathepsin b-like and cathepsin l-like activities fell below control values initially, but from week 8 of the immunosuppressive treatment significant increa ...19911894363
pulmonary manifestations of hiv infection in children.we retrospectively reviewed the spectrum, course, and outcome of pulmonary diseases in 66 children with aids, hospitalized between 1982 and 1988, prior to the use of zidovudine. fifty-two of the 66 (79%) patients developed pulmonary problems. in fifty-two percent of all patients, a pulmonary problem was the first symptom of hiv infection. the most common respiratory illness requiring hospitalization was an episode of respiratory distress with normal pao2 and unchanged x-ray with a 9.7 +/- 6.8 da ...19911896230
[pneumomediastinum and pneumocystis carinii pneumonia]. 19911896604
[diagnosis of pneumocystis carinii pneumonia in hiv-positive patients]. 19911897054
[therapy of hiv infection (aids)].the stages of human immunodeficiency viruses (hiv) life cycle are described as guide to therapeutic intervention. practical therapeutic recommendations are given. they should be directed to viruses as the causal agent and to the features of opportunistic infections as well as of associated malignant tumors. recently 3 progresses could be reached: (1) the application of azidothymidine in the latency phase, when the number of cd4 positive cells decreases below 500/mm3, whereby the progression of t ...19911897284
case report: hypothyroidism due to pneumocystis carinii thyroiditis in a patient with acquired immunodeficiency syndrome.pneumocystis carinii is the most common cause of opportunistic pulmonary infection in aids patients and disseminated disease is being recognized with increasing frequency. we describe a patient with cavitary pulmonary disease, lymphadenopathy, thyroiditis, and associated hypothyroidism, all a result of p. carinii. the organism was easily demonstrated in a fine-needle aspirate specimen of the thyroid. this is the second reported case of clinically apparent pneumocystis thyroiditis and the first r ...19911897563
interaction of cytokines and alveolar cells with pneumocystis carinii in vitro.although deficient cellular immune function is a major predisposing factor in the development of pneumocystis carinii pneumonia, the mechanisms involved in cellular immune surveillance against p. carinii have not been defined. when p. carinii were separated from rat cells by a semipermeable membrane, alveolar macrophages secreted substances lethal to p. carinii only when the macrophages were activated by interferon-gamma; normal macrophages were ineffective. type ii alveolar epithelial cells cau ...19911899874
diabetes mellitus presenting with ketoacidosis following pentamidine therapy in patients with acquired immunodeficiency syndrome.patients with acquired immunodeficiency syndrome (aids) are at risk from many endocrine complications. pentamidine has been recognised for its potential to cause symptomatic, and even life-threatening hypoglycaemia. we report two cases of diabetes mellitus presenting with ketoacidosis 3 to 4 months after pentamidine therapy for pneumocystis carinii pneumonia (pcp), and review our experience of dysglycaemia in 58 patients with aids treated with pentamidine. these cases emphasise the potential for ...19911900521
low-dose intermittent trimethoprim-sulfamethoxazole for prevention of pneumocystis carinii pneumonia in patients with human immunodeficiency virus infection.the important role of chemoprophylaxis for the prevention of pneumocystis carinii pneumonia (pcp) in human immunodeficiency virus type 1 (hiv)-infected patients is undisputed. the most cost-effective regimen, however, is unknown. we reviewed our experience at two hospitals in the new york city area in which low-dose, intermittent therapy with the combination of trimethoprim and sulfamethoxazole was used to prevent pcp in hiv-infected patients. during a total of 202 months of primary prophylaxis ...19911901482
uptake of pneumocystis carinii mediated by the macrophage mannose receptor.human exposure to pneumocystis carinii is common but, in the absence of acquired or genetic dysfunction of either cellular or humoral immunity, exposure rarely leads to illness. although alveolar macrophages can degrade p. carinii, macrophage receptors involved in p. carinii recognition have not been clearly defined. characterization of a predominant surface glycoprotein of the high mannose type led us to investigate the role of the macrophage mannose receptor in this process. we report here tha ...19911903183
enterococcal meningitis in an hiv positive haemophilic patient.a 25 year old, human immunodeficiency virus (hiv) seropositive, severe haemophilic patient was treated for suspected pneumocystis carinii infection with high dose intravenous cotrimoxazole and subsequently with prednisolone. when he improved he was discharged on oral treatment only to return two days later, extremely unwell, with headaches, fever, sweats, tachycardia and hypotension. a lumbar puncture showed modest neutrophil pleocytosis but despite empirical antibiotic treatment with intravenou ...19911906898
cost and benefit of secondary prophylaxis for pneumocystis carinii pneumonia.to determine the relative cost and benefit of aerosolized pentamidine and the combination product of sulfamethoxazole and trimethoprim sulfate as secondary prophylaxis for pneumocystis carinii pneumonia.19911907671
preventing secondary infections among hiv-positive persons.secondary infectious diseases contribute substantially to morbidity and mortality of people infected with human immunodeficiency virus (hiv). the authors developed comprehensive, practical recommendations for prevention of infectious complications in hiv-infected people. recommendations are concerned with the pathogens that are more common or more severe in hiv-infected people. several infectious complications can be prevented by avoiding ingestion of contaminated food or water. zoonoses can be ...19911910184
high-dose igg for neutropenic patients with acquired immunodeficiency syndrome (aids).leukocytopenia and bacterial infections are common and serious complications in patients with aids. we report here on three patients in whom the administration of high igg doses led to gradual (two patients) or prompt (one patient) increases in circulating leukocyte counts (from 200-600 to 2500-5900/microliters), inducing definite improvement in two patients; one patient died from pneumocystis carinii pneumonia. although the rise in leukocyte counts lasted for only approximately 3 weeks, high-do ...19911912034
[pneumocystis carinii pneumonia and spontaneous pneumothorax]. 19911912183
infections in the compromised child.children receiving chemotherapy for malignant diseases show different patterns of infection depending on their underlying disease and its therapy. granulocytopenia carries the risk of bacterial infection, and also, if prolonged, of fungal infection. impairment of cell-mediated immunity predisposes to infections with pneumocystis carinii and is thought to be responsible for severe primary infections with varicella and measles, as well as the severe cytomegalovirus infections seen after allogeneic ...19911912668
possible prevention of pneumocystis carinii pneumonia by pentamidine aerosol after bone marrow transplantation. 19911912958
immunopathogenesis of pneumocystis carinii infection. 19911919293
infectious complications of pediatric liver transplantation.twenty-five pediatric orthotopic liver transplantations (olts) performed in 22 patients at sainte-justine hospital were reviewed for infections complications. one patient died within 12 hours posttransplantation and is excluded. the patients had an average age of 6.1 years (range, 1.25 to 19 years) and an average weight of 20.4 kg (range, 11 to 55 kg). two patients (9%) were cytomegalovirus (cmv) seropositive and 9 of 19 patients (48%) were epstein-barr virus (ebv) seropositive preoperatively. f ...19911919982
vitiligo and chronic photosensitivity in human immunodeficiency virus infection.a 56-year-old man was admitted with hemiparesis and shortness of breath. he was positive to human immunodeficiency virus (hiv) antibody and was diagnosed as acquired immunodeficiency syndrome (aids) with kaposi's sarcoma and pneumocystis carinii pneumonia. he developed chronic photosensitivity and vitiligo preceding the onset of the aids-related complex (arc). association of the two skin lesions with hiv infection is very rare. although the role of hiv infection in these skin lesions is not sign ...19911920968
[a case of pneumocystis carinii pneumonia with bronchial asthma following long-term corticosteroid therapy].a 50-year-old man, who developed bronchial asthma at the age of 43 and was treated continuously with corticosteroids from the beginning of the first treatment, was admitted with exacerbation of exertional dyspnea. in spite of various treatments for bronchial asthma, such as theophylline, beta-stimulants, anti-allergic drugs and steroid-inhalation, asthmatic symptoms did not improve and he continued to receive intravenous administration of steroids. five months after admission, he suddenly develo ...19911920986
pneumocystis carinii pneumonia in adults without predisposing illnesses. 19911922231
pneumonia. pearls for interpreting patients' radiographs.the chest radiograph can detect pneumonia, but laboratory evaluation is needed to determine the specific causative organism. however, before these results become available, a presumptive diagnosis can be made with the help of chest radiography. a lobar pattern on radiography is usually produced by pneumococcal and klebsiella infections. a lobular (bronchopneumonia) pattern may be produced by staphylococcus, gram-negative organisms, and anaerobes. an interstitial pattern results from viral, mycop ...19911924016
the incidence and distribution of mycoplasma fermentans (incognitus strain) in the chicago aids autopsy series: an immunohistochemical study. chicago associated pathologists.mycoplasma incognitus is a recently described organism that was originally isolated by shyh-ching lo from spleen and kaposi's sarcoma (ks) tissue of patients with aids. the mycoplasm has since been found in selected aids autopsy cases in which there were tissues with unexplained areas of necrosis. mycoplasma incognitus is now known to be closely related to mycoplasma fermentans. in order to determine the incidence and distribution of m. fermentans/m. incognitus in an unselected series, we perfor ...19911924279
[which compressor should be used to deliver pentamidine aerosols with the respirgard ii?].prophylaxis against pneumonia due to pneumocystis carinii is most often carried out using pentamidine administered as an aerosol. for reasons both of comfort and cost this technique should be developed at home or at least in an extra-hospital environment. using the respirgard ii as the nebuliser of reference this requires a compressor. we have assessed four different compressors and compared these to pressurised oxygen used in a hospital environment. during the course of nebulisation with a pent ...19911924976
empiric therapy for the immunocompromised host.the use of empiric therapy for immunocompromised hosts has been one of the major advances in the management of such patients. such therapy has been put into practice primarily for patients with neutropenia induced by cytotoxic chemotherapy. the empiric antibiotic regimens include in their coverage the bowel, skin, and intravenous-catheter flora anticipated for patients in a particular hospital. less often, physicians treat empirically for opportunistic infections that complicate defects in helpe ...19911925322
[antiretroviral therapy in switzerland 1991].zidovudine (azidothymidine, retrovir) and ddi (di-deoxy-inosine, videx) interfere with the multiplication of hiv by incorporation into nascent dna chains and interruption of the further linking of nucleotides. zidovudine lowers early mortality in patients with aids and pneumocystis carinii pneumonia. however, much of the effectiveness of zidovudine is lost later on; the average prolongation of life in treated patients is estimated to be about 1 year. about two thirds of patients with aids can be ...19911925447
[ambulatory therapy and prevention of the most frequent hiv-associated opportunistic infections].earlier diagnosis and improved therapies for the opportunistic infections have led to improved quality of life as well as survival time of patients with advanced hiv-related immunodeficiency. most of the therapies can be administered on an outpatient basis. outpatient treatment further contributes to improving the quality of life of the patients. presentation, clinical aspects, treatment and prophylaxis of the five most frequent opportunistic infections in hiv-infected patients with advanced imm ...19911925448
incidence of qt interval prolongation during pentamidine therapy of pneumocystis carinii pneumonia. 19911927925
case report: chlamydia pneumoniae pneumonia in an hiv-infected man.we report a case of an hiv-infected adult with chlamydia pneumoniae. our patient presented with a clinical picture suggestive of pneumocystis carinii pneumonia (pcp), but did not respond to empiric anti-pcp therapy. the diagnosis was eventually confirmed by bronchoscopy and serology. c. pneumoniae pneumonia should be considered in the differential of pathogens that cause interstitial infiltrates in hiv-infected persons.19911928225
epidemiologic patterns of upper respiratory illness and pneumocystis carinii pneumonia in homosexual men.the relationship between self-reported upper respiratory illness symptoms (uri) and human immunodeficiency virus type 1 (hiv-1) was examined in homosexual men using semiannual visits from 1984 to 1988. temporal and geographic patterns of pneumocystis carinii pneumonia (pcp) diagnosis in these men during the same time period are also described. uri, including acute sinusitis, was reported more often by 916 hiv-1-seropositive participants than by 2,161 seronegative participants (32.21 versus 28.86 ...19911928944
effect of aerosolized pentamidine prophylaxis on the diagnosis of pneumocystis carinii pneumonia by induced sputum examination in patients infected with the human immunodeficiency virus.this study assessed the effect of aerosolized pentamidine prophylaxis on the clinical presentation and diagnostic sensitivity of induced sputum examination for pneumocystis carinii pneumonia. between january 1, 1988 and october 27, 1990, 348 induced sputum examinations were performed as the initial diagnostic procedure for p. carinii pneumonia in patients infected with the human immunodeficiency virus (hiv). medical records were reviewed for all induced sputum examinations, and the study group c ...19911928945
mode of presentation and diagnosis of bacterial pneumonia in human immunodeficiency virus-infected patients.bacterial pneumonia (bp) has recently been reported to be more frequent in human immunodeficiency virus (hiv)-infected patients than in normal hosts. this study reviews the clinical and radiologic manifestations of bp in 132 consecutive pulmonary episodes over a 15-month period. bp was defined on a clinical basis as a pulmonary infiltrate accompanied by fever and improving in a few days with conventional antibiotics (trimethoprim-sulfamethoxazole excluded). in patients undergoing bronchoscopy (9 ...19911928971
treatment for cerebral toxoplasmosis protects against pneumocystis carinii pneumonia in patients with aids. the swiss hiv cohort study.to determine whether long-term maintenance treatment for toxoplasmosis protects against pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome (aids).19911929023
hiv infection and pneumocystis carinii pneumonia--bronchoscopic diagnosis in two patients.pneumocystis carinii pneumonia is extremely common in patients with the acquired immunodeficiency syndrome (aids). diagnostic techniques vary between different institutions depending on availability of expertise. we have limited experience in the workup and evaluation of patients with human immunodeficiency virus infection because we have at present only 56 reported cases of hiv positive individuals. we report here two cases where pneumocystis carinii pneumonia was the index illness and the diag ...19911929187
susceptibility of pneumocystis carinii to artemisinin in vitro.the susceptibility of pneumocystis carinii to artemisinin (qinghaosu) was determined in short-term primary culture. in untreated cultures, trophozoites increased an average of fivefold over 4 days. inhibition of parasite growth in cultures treated with artemisinin at concentrations as low as 0.5 microm was seen. in contrast, artemisinin concentrations up to 100 microm had no effect on feeder layer cells.19911929266
pneumocystis carinii dihydrofolate reductase used to screen potential antipneumocystis drugs.pneumocystis carinii was obtained in high yield from the lungs of immunosuppressed rats by rupturing mammalian host cells, washing away the soluble mammalian dihydrofolate reductase, and harvesting intact organisms in association with the mammalian plasma membranes. p. carinii dihydrofolate reductase, measured in the 100,000 x g supernatant from sonicated organisms, was obtained in yields ranging up to 62 iu per rat. the enzyme prepared in the presence of protease inhibitors was stable when froz ...19911929292
surgical management of pneumothorax in patients with acquired immunodeficiency syndrome.pneumocystis carinii pneumonia in a patient with acquired immunodeficiency syndrome may cause severe alveolar damage, resulting in pneumothoraces that are often bilateral, recurrent, and refractory to accepted methods of treatment. the clinical features, management, and follow-up results were assessed in 22 consecutive patients who presented with a pneumothorax and acquired immunodeficiency syndrome. seventeen patients died within the time frame of this study. their average survival time was 147 ...19911929829
detection of antibody formation in mice, rats and rabbits immunized with different pneumocystis carinii antigens.antibody formation to p. carinii of human origin was determined by an indirect immunofluorescence antibody assay (ifa) after immunization of mice, rats and rabbits with pronase-treated whole cysts and soluble antigen in order to obtain more detailed data about the production of polyclonal antibodies. antibody titre profiles over defined periods have shown that noticeable differences between the immunoreactions to whole cysts and soluble antigen occur. the soluble antigen produced an earlier and ...19911930560
99mtc-human immunoglobulin (hig) in aids patients: first results.scintigraphy with 99mtc labelled human polyclonal immunoglobulin was performed in 16 patients with ascertained or suspected aids-related infections. 99mtc-hig lung scanning was compared, in 11 patients, with 67ga scintigraphy, chest x-ray and high resolution lung ct. 67ga and 99mtc-hig were concordantly positive in five cases of bal-ascertained pneumocystis carinii pneumonia (pcp), while one of them was rx and ct negative. x-ray, 67ga and 99mtc were concordantly negative in 5 cases. 99mtc-hig yi ...19911932171
guidelines for pneumocystis carinii pneumonia prophylaxis in children issued. 19911934917
urine pentamidine as an indicator of lung pentamidine in patients receiving aerosol therapy.to determine if urine pentamidine was reflective of lung pentamidine, we compared levels of the drug in bronchoalveolar lavage fluid and simultaneously obtained urine. thirty-one patients who were receiving aerosolized pentamidine either as treatment or as prophylaxis underwent bal and submitted urine samples for pentamidine analysis. pentamidine was analyzed in both phases of bal fluid (supernatant and cell pellet) and in urine using high performance liquid chromatography. urine results were no ...19911935274
pneumothorax with pneumocystis carinii pneumonia in aids. incidence and clinical characteristics.a retrospective review of the charts of patients with the acquired immunodeficiency syndrome (aids) was performed at three university-affiliated teaching hospitals in denver between may 1982 and april 1987. patients were evaluated for the presence or absence of pneumocystis carinii pneumonia (pcp) and for the occurrence of pneumothorax at any time during their clinical course. the incidence of pneumothorax in aids patients with pcp was 9.0 percent (8/89), compared with 0 percent (0/45) in aids p ...19911935275
diagnostic approach to pneumocystis carinii pneumonia in the setting of prophylactic aerosolized pentamidine.recurrent pneumocystis carinii pneumonia is common in patients with the acquired immunodeficiency syndrome who receive prophylaxis with aerosolized pentamidine. in this setting, the number of organisms is reduced and the clinical presentation may be altered. these observations have led to doubts regarding the use of induced sputum to diagnose pcp in patients receiving prophylactic ap. to determine if the examination of induced sputum is useful for patients receiving prophylactic ap, we examined ...19911935293
apical pneumocystis carinii pneumonia in aids patients not receiving inhaled pentamidine prophylaxis.isolated apical pneumocystis carinii pneumonia might develop in aids patients receiving aerosolized pentamidine prophylaxis. demonstrated here are two cases of apical p carinii pneumonia occurring in patients not receiving inhaled pentamidine prophylaxis. such isolated apical localization of p carinii should be differentiated from tuberculosis and fungal infection.19911935316
pulmonary cytology in lung transplant recipients: recent trends in laboratory utilization.the value of bronchoscopy for the diagnosis of rejection and opportunistic infection in lung transplant recipients is controversial. we review our experience with pulmonary cytology obtained from 10 lung transplant recipients during the first 15 mos of the transplantation program at cedars-sinai medical center and compare the efficacy of pulmonary cytology for the diagnosis of opportunistic infectious agents with that of histology and microbiology. our study encompasses 1,465 post-transplant day ...19911935512
which apparatus for inhaled pentamidine? a comparison of pulmonary deposition via eight nebulisers.aerosolised pentamidine 300 mg in 5 or 6 ml solution was administered via 8 different nebuliser systems to 12 patients with acquired immunodeficiency syndrome. using 99mtc human serum albumin as an indirect marker for pentamidine, pulmonary, extrapulmonary (gastric and oropharyngeal) and alveolar deposition of pentamidine were measured using a gamma camera. side effects (visual analogue scales) and changes in lung function associated with each treatment were also quantified. deposition was compl ...19911936233
evaluation of immune parameters in hiv+ subjects reporting adverse reactions to sulfamethoxazole.trimethoprim-sulfamethoxazole (tmp-smx) is frequently used in human immunodeficiency virus (hiv)-infected patients (hiv+) for treatment or prophylaxis of pneumocystis carinii pneumonia (pcp). up to 80% of those patients report adverse reactions to that drug combination. to test the hypothesis that these reactions are immunologically mediated, we quantitated specific igg and ige smx-human serum albumin (hsa) antibodies and immune complexes (ic) in hiv+ patients and in hiv controls. patients with ...19911937883
superiority of methylprednisolone over dexamethasone for induction of pneumocystis carinii infection in rats.because of difficulties in in vitro cultivation, the basic pneumocystis carinii studies have been carried out on animal models, mainly on rodents immunosuppressed by corticosteroids. commonly used dexamethasone and methylprednisolone procedures were evaluated. the intensity of infection in rats was statistically significantly higher after 9 weeks' immunosuppression with methylprednisolone than with dexamethasone.19911939591
complications of immunosuppression associated with weekly low dose methotrexate.complications of immunosuppression are thought to be rare with the use of low dose pulse methotrexate (mtx) for nonneoplastic conditions. we describe 4 complications of immunosuppression observed in a group of 41 patients who had received mtx for at least 6 months, during a 2-year period. we report the first case of a reversible lymphoproliferative disorder similar to that reported with immunosuppressive therapy associated with organ transplantation. two cases of disseminated herpes zoster and 1 ...19911941818
pneumocystis carinii pneumonia associated with methotrexate therapy in rheumatoid arthritis.opportunistic infections occur in patients with rheumatic diseases treated with low dose methotrexate (mtx) with or without other immunosuppressants. our case report illustrates a fatal case of pneumocystis carinii pneumonia in a patient with rheumatoid arthritis treated with low dose mtx and glucocorticoid. a review of the literature reveals other opportunistic infections such as cryptococcus, nocardia, and herpes zoster presenting in such patients. these occurrences suggest that mtx should be ...19911941836
low dose methotrexate therapy for rheumatoid arthritis complicated by pancytopenia and pneumocystis carinii pneumonia.in a patient with rheumatoid arthritis pancytopenia and pneumocystis carinii pneumonia occurred during low dose methotrexate therapy. this case emphasizes the potential development of opportunistic infections even with low dose methotrexate. pneumocystis carinii pneumonia resembles methotrexate induced pneumonitis. therefore opportunistic infections should be considered before a definite diagnosis of methotrexate induced pneumonitis is made.19911941837
pneumocystis carinii pneumonia.pneumocystis carinii pneumonia (pcp) is the most common index diagnosis in patients with acquired immunodeficiency syndrome (aids). eighty percent of aids patients will eventually develop pcp. common presenting symptoms are shortness of breath, cough, weight loss, and fever. the chest radiograph typically reveals a diffuse, bilateral, symmetric, fine-to-medium reticulonodular pattern of opacities. upper lobe disease has been reported recently in patients who have undergone prophylactic therapy w ...19911942193
the management of early human immunodeficiency virus infection.the outcome of treatment in patients with early asymptomatic hiv disease has recently improved. clinical trials with zidovudine have demonstrated efficacy and greatly reduced toxicity when the drug is used in asymptomatic hiv-infected persons who have fewer than 500 cd4+ cells/mm3, and resistance to this drug in these patients is less frequent and severe. also, the optimum dosage of zidovudine is less than previously believed, probably in the range of 500-600 mg daily given in oral divided doses ...19911942200
pulmonary disease in children with aids.children with acquired immunodeficiency syndrome (aids) may present with recurrent pneumonias or chronic debilitating illness. the chest radiographs of these patients demonstrate homogeneous densities representing staphylococcal or other pyogenic infections. pneumocystis carinii pneumonia produces a diffuse, symmetric, fine-to-medium, reticulonodular pattern. lymphocytic interstitial pneumonitis, a disease that is now an index diagnosis of aids in children under 13, may appear as a chronic, diff ...19911942201
racial and ethnic differences in outcome in zidovudine-treated patients with advanced hiv disease. zidovudine epidemiology study group.objectives--to determine if racial-ethnic differences exist in survival, disease progression, and development of myelosuppression in zidovudine-treated patients with advanced human immunodeficiency virus (hiv) disease. design--prospective observational study. setting:-hospital and private clinics in 12 metropolitan centers. patients:-the study included 754 non-hispanic white, 165 black, and 106 hispanic patients with the acquired immunodeficiency syndrome (aids) or advanced aids-related complex ...19911942423
recurrent pneumocystis carinii pneumonia with long interval showing disparate radiographic findings.a case of recurrent pneumocystis carinii pneumonia with a long interval between episodes and each episode showing a different radiographic appearance is reported. the radiographic finding in the initial infectious episode was bilateral, patchy, alveolar infiltrate predominantly in the upper and middle lung zones and that in the second infectious episode, six and a half years later, showed bilateral interstitial infiltrate predominantly in the middle and lower lung zones. t cell immunity expresse ...19911942647
upper lobe relapse of pneumocystis carinii pneumonia during aerosolized pentamidine prophylaxis.a patient with a history of pneumocystis carinii pneumonia (pcp) inhaled aerosolized pentamidine (ap) for secondary prophylaxis of pcp. nine months after the first pcp episode he presented with pulmonary upper-lobe infiltrations demonstrated by chest x-ray, and bronchoalveolar lavage confirmed the diagnosis of pcp. the clinical course and possible explanations for this unusual form of pcp are presented. the case emphasizes the importance of clinical controls for early diagnosis of relapse of pcp ...19911942958
a preliminary evaluation of 566c80 for the treatment of pneumocystis pneumonia in patients with the acquired immunodeficiency syndrome.the drug 566c80 is an investigational hydroxynaphthoquinone that is active against pneumocystis carinii in vitro and in animal models. initial studies in humans indicate that 566c80 is safe and has adequate bioavailability after oral administration.19911944437
presumed pneumocystis carinii choroiditis. unifocal presentation, regression with intravenous pentamidine, and choroiditis recurrence.pneumocystis carinii choroiditis is a well-documented but rare infection that has been described as a bilateral, multifocal process. treatment efficacy has not been well established. in this report, three cases of presumed p. carinii choroiditis that developed during aerosolized pentamidine therapy for the prophylaxis of p. carinii pneumonia are described. all patients had unilateral choroiditis, and two patients were first observed to have unifocal choroiditis. in all patients, choroidal lesion ...19911945309
nebulized pentamidine for the prevention of pneumocystis carinii pneumonia in aids patients: experience of 173 patients and a review of the literature.nebulized pentamidine is increasingly used for the prevention of pneumocystis carinii pneumonia in hiv antibody-positive patients. we report our experience of the efficacy and tolerance of a high dose regimen (300 mg every second week) in 173 hiv-positive patients over a 2 1/2-year period. only seven episodes of p. carinii pneumonia occurred but 48 patients (28 per cent) died of other aids-related illnesses. patients who had never had an episode of p. carinii infection were less likely to accept ...19911946942
[allogenic bone marrow transplantation in acute leukemia].allogeneic bone marrow transplantation (bmt) allows application of supraletal chemoradiotherapy thereby sparing of hemopoietic tissue. after ablation of hematopoiesis bone marrow of a healthy and hla-identical donor has to be transplanted. during aplasia patients require maintenance in sterile units (reverse isolation or lamina air flow). these together with intestinal decontamination is aimed to reduce the occurrence of infections in these severely immunocompromised patients. to minimize bmt-sp ...19911949849
trimethoprim/sulfamethoxazole concentrations in pneumocystis carinii pneumonia. 19911949971
pneumocystis carinii in pleural fluid. the cytologic appearance.we describe the cytologic appearance of pneumocystis carinii in pleural fluid of a patient with acquired immunodeficiency syndrome and a rapidly accumulating pleural effusion. the diagnosis of p carinii infection was made by examination of air-dried, diff-quik-stained cytospin preparations of the pleural fluid. the diagnostic appearances of p carinii organisms stained by this method and by the papanicolaou stain are reviewed. the unusual predominance of the trophozoite forms of the organism in t ...19911950331
establishment of pneumocystis carinii infection in a rat population. 19911950847
use of low-dose trimethoprim-sulfamethoxazole thrice weekly for primary and secondary prophylaxis of pneumocystis carinii pneumonia in human immunodeficiency virus-infected patients.we conducted an open prospective clinical trial to evaluate the efficacy and toxicity of trimethoprim-sulfamethoxazole given as one double-strength tablet thrice weekly for primary and secondary prophylaxis of pneumocystis carinii pneumonia (pcp) in human immunodeficiency virus-infected (hiv+) patients. a total of 104 hiv+ patients were evaluated, with 74 being in the primary prophylaxis group and 30 being in the secondary prophylaxis group. all except six patients received concomitant zidovudin ...19911952835
pharmacokinetics and adverse effects of 20-mg/kg/day trimethoprim and 100-mg/kg/day sulfamethoxazole in healthy adult subjects.the pharmacokinetics of trimethoprim-sulfamethoxazole were studied in 12 healthy adult subjects receiving trimethoprim at 20 mg/kg of body weight per day and sulfamethoxazole at 100 mg/kg/day, which is the conventional dose for treating pneumocystis carinii pneumonia (pcp). daily doses were evenly divided and orally administered every 6 h for 3 days. trimethoprim, sulfamethoxazole, and n4-acetylsulfamethoxazole concentrations in serum and urine were measured by high-performance liquid chromatogr ...19911952863
cutaneous pneumocystis carinii infection in patients with acquired immunodeficiency syndrome.extrapulmonary infection with pneumocystis carinii is an uncommon event in which the skin may be affected rarely. all cases heretofore described in immunocompromised hosts have involved the external auditory canal and mastoid areas. we describe two patients with acquired immunodeficiency syndrome and extrapulmonary cutaneous p carinii infection that involved the glabrous skin. the first was a 31-year-old white man seropositive for human immunodeficiency virus with prior episodes of p carinii pne ...19911952976
pneumocystis carinii pneumonia-upper lobe recurrence following cotrimoxazole. 19911953521
[computed tomography of disseminated extrapulmonary pneumocystis carinii infection]. 19911954370
occurrence of pneumocystis carinii organisms in a peritoneal effusion from a patient with the acquired immunodeficiency syndrome.we describe a unique case of pneumocystis carinii organisms within a peritoneal effusion of a patient with acquired immunodeficiency syndrome (aids). the patient, a 28-yr-old homosexual male with profound immunosuppression, presented with splenomegaly and ascites. a peritoneal tap was performed for diagnostic purposes. cytologic examination of the cytospin specimen showed reactive mesothelial cells along with aggregates of debris reminiscent of the foamy exudates seen in the alveoli of lungs inf ...19911954838
lung 99mtc dtpa transfer in renal disease and pulmonary infection.the half-time of transfer of 99mtc dtpa (t50) is a useful method of assessing lung epithelial permeability, which has been shown to be altered in patients with acquired immunodeficiency syndrome (aids) who have pneumocystis carinii pneumonia (pcp). the present study was designed to assess the usefulness of the t50 measurement in evaluating patients with renal transplants, breathlessness, and fever. an assessment was also made of the effect of renal failure on the t50 result. sixty-eight non-smok ...19911956558
[diagnosis of pneumocystis carinii pneumonia (pcp) in hiv-positive patients]. 19911957367
aspergillosis in the acquired immunodeficiency syndrome.the role of aspergillus species as a pathogen in acquired immunodeficiency syndrome (aids) has not been clearly defined. from 1984 to 1989, more than 2,000 aids patients were seen at beth israel medical center, new york. aspergillus was isolated in ten patients; seven had invasive disease and three had noninvasive disease. invasive pulmonary aspergillosis (ipa) was diagnosed in six patients and invasive renal aspergillosis was found in one patient. five were homosexual men and two were intraveno ...19911959405
nebulized pentamidine as prophylaxis for pneumocystis carinii pneumonia. 19911960126
disseminated pneumocystis carinii infection in aids.eight patients with aids and pneumocystis carinii infection were studied. protean manifestations were a feature not untypical of disseminated pneumocystosis. aerosolised pentamidine as prophylaxis against p carinii pneumonia was ineffective at suppressing dissemination. the knowledge that extrapulmonary infection can occur has implications for the detection and treatment of, and prophylaxis against, p carinii infection. the survival of patients with disseminated pneumocystosis is particularly po ...19911960214
pneumocystis carinii pneumonia despite prophylaxis in children with human immunodeficiency virus infection. 19911960625
disseminated pneumocystis carinii infection in aids. 19911962644
evolving concepts of infection by pneumocystis carinii. 19911707512
comparison of papanicolaou's stain with the gomori methenamine silver (gms) stain for the cytodiagnosis of pneumocystis carinii in bronchoalveolar lavage (bal) fluid.the cytodiagnosis of pneumocystis carinii (pc) in bronchoalveolar lavage (bal) fluids has traditionally required a special stain such as gomori's methenamine silver (gms) stain. recent reports indicate that identification of foamy alveolar casts (facs) with papanicolaou's (pap) stain may provide a sensitive and less complicated way of making the diagnosis. to confirm these observations, results on a series of 318 bals were reviewed. pc was identified on 65 (20%) specimens from 54 patients. pap s ...19911707590
follow-up bronchoalveolar lavage in aids patients with pneumocystis carinii pneumonia. pneumocystis carinii burden predicts early relapse.we performed an analysis of the value of repeat bronchoalveolar lavage (bal) at 21 days to identify patients at risk for early relapse with pneumocystis carinii pneumonia. patients with p. carinii pneumonia and the acquired immunodeficiency syndrome (aids) were asked to participate in this study. all patients had p. carinii identified on methenamine silver stain of bal fluid. bal fluid was also stained with a modified wright-giemsa technique. the wright-giemsa stain was done to determine the cel ...19911708950
diagnosis of pneumocystis carinii by cytologic examination of papanicolaou-stained sputum specimens. 19911709084
cytology of treated and minimal pneumocystis carinii pneumonia and a pitfall of the grocott methenamine silver stain.to clarify the role of foamy alveolar casts (facs) in the diagnosis of pneumocystis carinii pneumonia (pcp), we retrospectively reviewed papanicolaou (pap)- and grocott methenamine silver (gms)-stained slides from 205 bronchial specimens submitted for suspected opportunistic lung infection. facs containing sporozoites were seen in 86 cases, all with positive gms. facs were absent in 119 cases with negative gms. in patients previously treated for pcp, pap showed fac-like material which lacked spo ...19911709086
assessing the adequacy of induced sputum for the evaluation for pneumocystis carinii pneumonia. 19911709326
comparison of monoclonal antibody and calcofluor white stains for the detection of pneumocystis carinii from respiratory specimens.three monoclonal antibody staining kits, from genetic systems, disease detection international, and meridian diagnostics, were compared with calcofluor white for the direct detection of pneumocystis carinii in respiratory specimens. of the 150 specimens tested, 23 were found positive for p. carinii by any of the four stains; 13 were bronchoalveolar lavage, 7 were induced sputum and 3 were expectorated sputum specimens. all stains detected the positive bronchoalveolar lavage specimens, the geneti ...19911709951
pneumocystis carinii organisms derived from rat and human hosts are genetically distinct. 19911711155
an identical epitope in pneumocystis carinii and toxoplasma gondii causing serological cross reactions.a monoclonal antibody raised against membrane proteins of toxoplasma gondii with molecular weights of 35 and 21 kda also reacts strongly and "specifically" with surface antigens of pneumocystis carinii with molecular weights of 394.2 and 69 kda when used in a direct immunofluorescence antibody test, on the one hand, and in a immunoblot after sodium dodecyl sulfate-polyacrylamide gel electrophoresis (sds-page), on the other. whether or not this observation might have any phylogenetic relevance re ...19911714080
examination of induced sputum in the diagnosis of pneumocystis carinii pneumonia.the results of the examination of sputum induced by the inhalation of nebulized hypertonic saline in the diagnosis of pneumocystis carinii pneumonia (pcp) are presented. in suspected cases of pcp in patients who were either hiv antibody positive or were receiving immunosuppressive therapy, 46 induced sputum specimens were stained using both grocott's modified gomori methenamine silver nitrate (gms) and immunofluorescence staining. in 12 specimens p. carinii cysts were detected by both methods, i ...19911717023
[the diagnosis of pneumocystis pneumonia (use of the bauer reaction for detecting pneumocystis carinii in pathological material]. 19911717754
the cytological diagnosis of pneumocystis carinii by fluorescence microscopy of papanicolaou stained bronchoalveolar lavage specimens.in a retrospective and prospective analysis fluorescence microscopy of papanicolaou stained bronchoalveolar lavage specimens has been applied to the diagnosis of pneumocystis carinii (pc) in routine cytology. the pneumocysts presented as circular structures of 5 microns in diameter and of brilliant green-yellow fluorescence surrounding two mirror image reniform structures. fluorescent inclusions of 1-3 microns diameter within the alveolar macrophages could be identified as remnants of pneumocyst ...19911718475
treatment and prophylaxis of pneumocystis carinii pneumonia in aids patients.pneumocystis carinii pneumonia (pcp) is seen in people with a defect in cell-mediated immunity. today the most common cause for this is the acquired immunodeficiency syndrome (aids). there have been some remarkable advances recently in the development of new drug regimens to combat this otherwise fatal infection. although cotrimoxazole (trimethoprim-sulfamethoxazole) is still the drug of first choice it cannot be tolerated by a significant proportion of patients, and therapies such as pentamidin ...19911723365
evaluation of calcofluor white [cfw] stain for detection of pneumocystis carinii. 19911724635
drug treatment of pneumonia in the hospital. what are the choices?mortality and morbidity of nosocomial pneumonia remain high. successful treatment of pulmonary infections depends on several factors including type of infection, offending pathogen, status of host defences, and adequate choice of antibiotic therapy. the physician's decision should aim at achieving antibiotic concentrations beyond the mic at the site of infection. gram-negative bacilli, notably pseudomonos aeruginosa, klebsiella pneumoniae and escherichia coli, remain the most frequent agents in ...19911724642
[morphology and function of macrophages in aids in broncho-alveolar lavages (bal)].hiv infects susceptible t-cell and mononuclear phagocyte targets. unlike the dramatic changes that occur with t-cells during hiv disease, changes in monocyte and macrophage phenotype and function are qualitatively minimal. the aim of the study was to quantitatively analyze the morphology of macrophages in broncho-alveolar lavages in patients without aids, with aids, with aids complicated by pneumocystis carinii and in carcinoma patients. in patients with aids, the nuclei of macrophages demonstra ...19911724812
[extrapulmonary manifestations of pneumocystis carinii infection in aids].between 1986 and 1990 we found in 7 out of 100 continuously performed aids-autopsies at auguste-viktoria-hospital (avh) an extrapulmonary manifestation of pneumocystis carinii (pc). 4 of these cases showed only a singular infiltration of pulmohilar lymphnodi, while the remaining 3 cases presented various other organ involvements: spleen, liver, kidney, adrenal gland, prostate gland, pancreas, myocardium, thyroidea and eyes. all these aids-patients had a chronic or relapsing pc-pneumonia with foc ...19911724821
[the epidemiology and acquired immunodeficiency syndrome--status and trends].up to june 1991 a total of 6,604 aids cases were reported to the central aids-registry at the federal health office. as typical for "pattern i" countries most of the aids-cases are homo/bisexual men (70%), followed by i.v. drug users (idu, 13%). however, the proportion of homo/bisexual men is constantly decreasing since 1986 while the proportion of idu's is increasing. as also observed in other industrialized countries a flattening off in the aids incidence curve is seen since 1989. probable rea ...19911724853
a common antigenic epitope expressed on human pneumocystis carinii.recently antigenic heterogeneity in human pneumocystis carinii (pc) isolates was observed in several laboratories. monoclonal antibodies (mab) were produced to human pc (pch) from a lung autopsy sample from a non-aids patient (mab group i, n = 10), or from bronchoalveolar lavage (bal) fluid from aids patients (mab group ii, n = 8). to detect pc antigen from specimens, indirect immunofluorescence and immunoblotting techniques were used. the reactivity was evaluated by using one autopsy sample fro ...19911726324
ultrastructural localization of epitopes recognized by monoclonal antibodies produced to rat pneumocystis carinii.the binding sites of five monoclonal antibodies (mab) developed against rat pneumocystis carinii were examined at the ultrastructural level by using a post-embedding labeling method. although all five mab reacted with the pellicle of p. carinii, they were divided into two groups by localization of binding sites. the mab 168.2.1, 174.2.1, and 215.2.1 reacted mainly with the electron-dense outer layer, whereas mab 227.1.1 and 228.1.1 labeled both the outer dense layer and the middle lucent layer. ...19911726325
epitope study and cdna screening of major surface glycoprotein of pneumocystis carinii.use of monoclonal antibodies against the major glycoprotein of pneumocystis carinii (p115) implicated the sugar moiety as being strongly antigenic. furthermore, monoclonal antibodies directed against the peptide portion of p115 were generated by using synthetic oligopeptides after amino acid sequencing was done on p115 proteolytic fragments.19911726327
assays for testing pneumocystis carinii viability.a series of classical vital stains and fluorescent indicator compounds were evaluated as viability assays of p. carinii. the combination of the acetoxymethyl ester of calcein with either ethidium homodimer or propidium iodide distinguished between live, dead and moribund organisms and provided high fluorescence intensity and low bleaching enabling photodocumentation at high magnifications.19911726329
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