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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
cytomegalovirus pneumonitis after cardiac transplantation.to evaluate the incidence and clinical features of cytomegalovirus (cmv) pneumonitis after cardiac transplantation, we identified 27 (16%) of 171 consecutive recipients in whom cmv pneumonitis was confirmed by strict diagnostic criteria. cytomegalovirus pneumonitis occurred in 6 (30%) of 20 patients treated with azathioprine and prednisone, and 8 (25%) of 32 patients treated with azathioprine, cyclosporine, and prednisone, but only 13 (11%) of 119 patients treated with cyclosporine and prednison ...19911645949
morbidity and mortality of patients with aids and first-episode pneumocystis carinii pneumonia unaffected by concomitant pulmonary cytomegalovirus infection.to determine the significance of cytomegalovirus (cmv) pulmonary coinfection with pneumocystis carinii pneumonia in aids, we examined the association of long- and short-term survival and morbidity (as defined by length of hospital stay) with recovery of cmv from bronchoscopy specimens and an indirect measure of virus titer in bronchoalveolar lavage fluid (the time to develop cmv cytopathology in culture) in 111 patients diagnosed with a first episode of p. carinii pneumonia. compared with 57 ind ...19911648316
[detection of human cytomegalovirus dna by in situ hybridization].a biotin labelled human cytomegalovirus (hcmv) dna probe of ecori d fragment (17kb) from hcmv ad 169 strain was prepared. in situ hybridization of hcmv was performed in paraffin section of tissues collected from an autopsy case of congenital and combined immunodeficiency syndrome associated with systemic hcmv and pneumocystis carinii infections. the pathological lesions of hcmv infection showed three different patterns: 1, necrotic granuloma type, 2, diffuse type, and 3, scattered type. hcmv dna ...19911648456
autopsy pathology and disease patterns in shiraz, iran, 1960-1974.the impact of 4300 serial autopsies performed in shiraz, iran, on scientific and clinical medicine is discussed. these studies in geographic pathology led to the recognition of the importance in disease patterns of persistent, life-long changes in the human immune response brought about by serious perinatal infection and/or malnutrition. elucidation of the pathogenesis of primary upper small intestinal lymphoma serves as an example of the importance of the field of geographic pathology for the u ...19911649795
infections following orthotopic liver transplantation.the epidemiology of infections associated with orthotopic liver transplantation is summarized herein, and approaches to prophylaxis are outlined. infection is a major complication following orthotopic liver transplantation, and more than half of transplant recipients develop at least one infection. the risk of infection is highest in the first month after transplantation, and the most common pathogens are bacteria and cytomegalovirus (cmv). bacterial infections usually occur in the first month, ...19911650245
surgical pathology of the liver in hiv infection.in the 6-year period 1984-1989, 101 liver biopsies or 'needle necropsies' from human immunodeficiency virus positive patients were examined histologically. of these, only nine showed no abnormality whatsoever. the commonest histological findings were either fatty change or changes related to co-existent chronic viral hepatitis. granulomas were seen in 15 cases, four of which were positive for acid-fast bacilli. a range of organisms were recorded: cytomegalovirus (4); histoplasma capsulatum (1); ...19911653181
disseminated histoplasmosis in an aids patient treated with itraconazole.a patient with aids presented with a fever, shortness of breath and a productive cough. a provisional diagnosis of pneumocystis carinii pneumonia was made; however, blood cultures and bone marrow examination revealed disseminated infection with histoplasmosis capsulatum. this was treated by itraconazole with initial success, but the patient relapsed while on maintenance therapy.19911655628
the causes of death in patients with human immunodeficiency virus infection: a clinical and pathologic study with emphasis on the role of pulmonary diseases.the clinical records and autopsy data of 75 patients dying with aids were reviewed to determine the frequency of individual diseases diagnosed premortem and postmortem, the significance of pulmonary processes found in the lungs at autopsy, and the clinical and pathologic causes of death. cytomegalovirus (cmv) infection was identified histologically either premortem or postmortem in 81% of patients. the lungs and adrenal glands were infected most commonly. only one-half of cmv infections were rec ...19911656164
[progress and problems in hospital infections: exemplified by pneumonia].nosocomial pneumonias have various etiologies and their development depends mainly on the underlying condition of the patients. intubated patients are prone to development of bacterial pneumonia from the oropharyngeal or gastric flora. prevention relies on reducing exogenous as well as endogenous colonization of the bronchotracheal tree: avoidance of cross-contamination, maintenance of a physiological gastric ph and, possibly, selective digestive decontamination. neutropenic patients may develop ...19911656522
clinical and serologic features of herpes simplex virus infection in patients with aids.we studied the natural history of herpes simplex virus (hsv) infection and its association with specific serum antibody in a sample of 68 hiv-infected patients with a first episode of pneumocystis carinii pneumonia at san francisco general hospital in 1986. seroprevalence was 66 and 77% for hsv-1 and hsv-2 antibody, respectively, by immunoblot assay. twenty-seven patients had 45 hsv outbreaks diagnosed during 739 patient-months of follow-up. median frequency of recurrence resulting in a medical ...19911657040
bilateral bronchoalveolar lavage in the diagnosis of opportunistic pulmonary infections.to further improve the diagnostic value of bronchoscopy in the immunosuppressed population presenting with diffuse pulmonary infiltrates, we prospectively investigated the utility of bilateral bronchoalveolar lavage (bal). we performed 62 bronchoscopies on 52 immunosuppressed patients. of the 52 patients, 33 had pulmonary infections. the yield for pneumocystis carinii pneumonia on bilateral bal was 94 percent (31/33), compared to the 84 percent (51/61) previously obtained with unilateral bal in ...19911657538
modulation of pneumocystis carinii adherence to cultured lung cells by a mannose-dependent mechanism.pneumocystis carinii is an opportunistic parasite that attaches to the alveolar epithelium during the initiation of pneumonia. it is unknown whether p. carinii recognizes specific receptors on the surface of lung cells. our study indicates that concanavalin a (con a), a lectin that recognizes mannose-containing glycoproteins, binds to p. carinii organisms in a saturable manner with a binding affinity of kd = 11 x 10(-6) mol/l and with 18.5 x 10(6) con a binding sites per p. carinii organism. con ...19911658169
spectrum of activity of azithromycin.in recent years, a number of newer macrolides have been developed. one such antibiotic is azithromycin, which has a 15-membered ring structure and is classed as an azalide. the limitations of erythromycin and the discovery of pathogenic bacteria such as campylobacter, legionella and chlamydia species provide incentives to study the usefulness of newer antibiotics of this class. azithromycin has good activity against staphylococci, streptococci, moraxella catarrhalis and other rapidly growing pyo ...19911662624
coexisting pneumocystis carinii pneumonia, cytomegalovirus pneumonitis and salmonellosis in systemic lupus erythematosus.infection with opportunistic organisms, either singly or in combination, is known to occur in immunocompromised patients. a patient with systemic lupus erythematosus who developed pneumocystis carinii pneumonia, cytomegalovirus pneumonitis, and salmonellosis is reported. she responded to early treatment with intravenous trimethoprim-sulphamethoxazole (20 mg/kg).19911663329
a comparison of several agents with two delivery systems for the prevention of airway narrowing induced by nebulised pentamidine isethionate.bronchial narrowing is the major side effect of inhaled nebulised pentamidine isethionate, used for the prophylaxis and treatment of pneumocystis carinii pneumonia. several agents and delivery systems were assessed for prophylaxis of bronchial narrowing in hiv-positive males receiving regular nebulised pentamidine isethionate. in a previous study we found the mean maximum fall in fev1 with nebulised pentamidine alone to be 21%. fev1 was measured before and after inhaling nebulised pentamidine, p ...19911663642
mitochondrial gene sequences show fungal homology for pneumocystis carinii.a 6.8 kilobase fragment of mitochondrial dna from pneumocystis carinii encodes for apocytochrome b, nadh dehydrogenase subunits 1, 2, 3, and 6, cytochrome oxidase subunit ii, and the small subunit of ribosomal rna. comparative sequence analysis with a series of organisms representative of the fungal and protozoan groups shows that p. carinii has, consistently, an average similarity of 60% with the fungi but only 20% with the protozoa. the data indicate homology with the fungi for this opportunis ...19911664905
[a case of smoldering adult t-cell leukemia complicated by various pulmonary infections].a 46-year-old man was admitted to oita medical college hospital on october 16, 1987, because of cough and sputum. chest x-ray and chest ct films showed diffuse reticulonodular shadow. the specimens obtained by transbronchial lung biopsy revealed cysts of pneumocystis carinii. abnormal lymphocytes with lobulated nuclei were found 2-7% of peripheral leucocytes. the anti htlv-i antibody was positive. according to these data, we diagnosed the patient as smoldering adult t cell leukemia with pneumocy ...19911665167
a survey of pneumocystis carinii infection in research mouse colonies in japan.to determine the frequency of pneumocystis carinii infection in mouse colonies maintained for biomedical research in medical colleges or medical faculties in universities in japan, 409 nu/nu mice were sent to 43 animal facilities from a p. carinii-free colony. the animals were housed for 6 months in groups of 3 to 10 animals per room, and examined for the presence of parasites and infection. colonies in 10 (24.4%) of 41 facilities were positive for the infection. of 383 animals in 69 rooms, the ...19911666138
the prognosis in hiv-infected patients with pneumonia. relation to microbiological diagnoses.ninety consecutive first-time fiberoptic bronchoscopies (fb) were performed on hiv-infected patients with pulmonary symptoms and radiographic evidence of active pneumonitis. microbiological data were analysed for acute and long-term prognostic significance. 56/90 (63%) patients had one type of microbiological agent recovered from fb, 22/90 (24%) patients had more types recovered, and 12/90 (13%) patients had no types recovered. nine patients (10%) died during the acute episode of pneumonia. a pr ...19911666357
[pneumocystis carinii pneumonia].the paper reports on a theme of important pediatric interest, pneumonia with pneumocystis carinii (pc), a more widespread affection lately, due to the progress in pediatric reanimation, on the one hand (that allowed the survival for a long time of several biologically handicapped infants) and as a consequence of the more and more common use of immunosuppressing therapy, on the other hand (malignant diseases, transplant of organs, etc.); another important role in the increase of the pc pneumonia ...19911667601
the impact of concomitant viral pathogens on the course of pneumocystis carinii pneumonia.a large retrospective study was conducted to evaluate the impact of culturing cytomegalovirus from the respiratory secretions of aids patients with pneumocystis carinii pneumonia. pneumocystis carinii was found in 220 (67%) of 327 episodes and cytomegalovirus was found in 106 (48%) of the p. carinii-positive patients. cytomegalovirus-positive and -negative patients were similar at baseline and had a similar number of hospital days, but had a lower incidence of early deterioration in oxygenation, ...19911667929
inhibition of topoisomerases from pneumocystis carinii by aromatic dicationic molecules.pentamidine and related derivatives inhibit an atp-dependent topoisomerase activity from pneumocystis carinii extracts. since it would be extremely difficult to purify ample quantities of the organisms to allow characterization of the enzyme and carry out drug binding experiments, we have begun the cloning of the topoisomerase genes with a goal towards expression of each gene in a heterologous system. following construction of genomic libraries in the vectors lambda dash and lambda zap, oligonuc ...19911667935
[diagnosis of pulmonary infections by specific etiologic agents in secondary immunocompromised patients].ten cases of pulmonary infections by the specific etiologic agents in immunocompromised patients secondary to diseases and/or drugs were reported. their infections included 5 tuberculosis, 4 pulmonary aspergillosis, 1 pneumocystis carinii and cytomegalovirus pneumonia. the early revelation of pulmonary abnormality, the sampling of non-contaminated diagnostic materials, the improvement of laboratory techniques, and a feasible scheme of clinical management for pulmonary infections in immunocomprom ...19911668066
prophylaxis against pneumocystis carinii pneumonia in children infected with human immunodeficiency virus. 19911669802
[respiratory complications in 44 patients with acquired immunodeficiency syndrome].observation was carried out of 44 patients affected with pulmonary pathology during the course of aids, each of whom presented a severe respiratory insufficiency, admitted to the clinic of infectious diseases between may 1987 and march 1989. in the patients suffering from their first respiratory infection, a lower mortality rate was observed (11/28, 39.2%) compared with the patients suffering from a second or successive infection (10/16, 62.5%). in sixteen cases, the etiological agent was pneumo ...19911670052
cigarette smoking: a modifier of human immunodeficiency virus type 1 infection?two hundred and two homosexual men enrolled in a prospective cohort study of aids risk were assessed for differences in the occurrence and progression of human immunodeficiency virus type 1 (hiv-1) infection with respect to cigarette smoking. among subjects who were initially seronegative, smokers were more likely than nonsmokers to become hiv-1 seropositive (p = 0.03). after seroconversion, serum beta 2-microglobulin and cd4+ lymphocyte levels were elevated in cigarette smokers relative to nons ...19911670588
pulmonary complications of combination therapy with cyclophosphamide and prednisone.oral cyclophosphamide and prednisone are standard treatment for some neoplasms and necrotizing systemic vasculitis and are advocated with increasing frequency for idiopathic interstitial lung disease. during a 15-month period, we observed four cases of acute respiratory failure from pneumocystis carinii pneumonia (pcp) in patients treated with oral cyclophosphamide and prednisone. one patient each had polyarteritis nodosa, wegener's granulomatosis, bronchiolitis obliterans with organizing pneumo ...19911670629
low-dose co-trimoxazole for prevention of pneumocystis carinii pneumonia in human immunodeficiency virus disease.the efficacy and tolerability of low, intermittent doses of co-trimoxazole (160 mg trimethoprim and 800 mg sulfamethoxazole given monday, wednesday, friday) for prophylaxis against pneumocystis carinii pneumonia (pcp) was assessed retrospectively in 116 patients with the acquired immunodeficiency syndrome (aids) and aids-related complex at high risk of pcp. 92% were receiving concomitant zidovudine. 71 with previous episode(s) of pcp were followed a mean of 18.5 months (range 3-42). 45 without p ...19911671479
[relationship between t-subsets and clinical aspects of hiv-associated diseases].hiv predominantly infects the cd4+ t cells, which during the progression of the disease are eliminated, causing an immune deficiency which renders the patients more susceptible to infections. to evaluate the relevance of the cd4+ t cell elimination and thus the clinical usefulness of cd4/cd8 subset determinations in hiv infected persons, we investigated whether analyses of 667 subset determinations of 365 patients correlated with clinical stages of hiv-infection (cdc classification). progress of ...19911671535
ditiocarb sodium (diethyldithiocarbamate) therapy in patients with symptomatic hiv infection and aids. a randomized, double-blind, placebo-controlled, multicenter study.we randomized 389 symptomatic patients with human immunodeficiency virus (hiv) infection to ditiocarb sodium (400 mg/m2 orally for 24 weeks) or a placebo. patients were well balanced according to centers for disease control (cdc) group, cd4+ cell number, and duration of disease prior to entry. ten new acquired immunodeficiency syndrome (aids)-defining opportunistic infections occurred in the treated patients and 21 in the controls. reduction of new opportunistic infections in the ditiocarb group ...19911671884
guidelines for prophylaxis against pneumocystis carinii pneumonia for children infected with human immunodeficiency virus.although guidelines have been established for prophylaxis against pneumocystis carinii pneumonia (pcp) for adults with human immunodeficiency virus (hiv) infection, they have not been available for children (1). experts in pediatric hiv infection (convened by the pediatric hiv resource center) independently reviewed recent data and provided recommendations to the u.s. public health service for pcp prophylaxis for hiv-infected or -exposed children. this report summarizes these deliberations and d ...19911672036
from the centers for disease control. guidelines for prophylaxis against pneumocystis carinii pneumonia for children infected with human immunodeficiency virus. 19911672167
clinical and laboratory correlates of pneumocystis carinii pneumonia in children infected with hiv.the case histories of 27 children with pneumocystis carinii pneumonia (pcp) who were followed up in the aids program at the children's hospital of new jersey, newark, are reviewed. the mean and median age at pcp diagnosis were 10.8 and 7.7 months, respectively. all of the children had other clinical evidence of infection with the human immunodeficiency virus that was documented prior to the diagnosis of pcp or found at the time of pcp diagnosis. most patients who presented to the hospital were a ...19911672168
cd4 t-lymphocyte counts and pneumocystis carinii pneumonia in pediatric hiv infection.the relationship between cd4 t-lymphocyte counts and infection with the human immunodeficiency virus (hiv) is retrospectively investigated for 266 hiv-infected and uninfected children who were born to infected women, including 39 with pneumocystis carinii pneumonia (pcp), in a population-based surveillance study. of 21 perinatally hiv-infected children with pcp only 10 (48%) had cd4 t-lymphocyte counts that were less than 500 x 10(6) cells/l (500 cells/mm3), compared with all 18 who were infecte ...19911672169
[pneumocystis carinii pneumonia in hiv infection. diagnosis, prognostic factors and curative treatment].the diagnosis of pneumocystis carinii pneumonia (pcp) rests on the isolation of this micro-organism in patients whose latest blood count, less than 2 months old, shows less than 250 cd4 lymphocytes per cubic mm and who present with signs of impaired lung function. bronchoalveolar lavage (bal) is the reference diagnostic method, but induced expectoration may be the initial examination, in which case bal is performed only when the latter fails or gives negative results. prognostic factors are thos ...19911672560
pneumocystis carinii pneumonia complicating somatostatin therapy of cushing's syndrome in a patient with metastatic pancreatic islet cell carcinoma and zollinger-ellison syndrome.described is the case of a 73-yr-old woman with metastatic pancreatic islet carcinoma that manifested initially as zollinger-ellison syndrome followed by onset of endogenous cushing's syndrome, who developed pneumocystis carinii pneumonia while on therapy with a long-acting somatostatin analog. although p. carinii pneumonia has been observed in patients with cushing's syndrome associated with other conditions, this is the first reported case in a patient with zollinger-ellison syndrome. heighten ...19911672788
primary prophylaxis for pneumocystis carinii pneumonia in hiv-infected people with cd4 counts below 200/mm3: a cost-effectiveness analysis.we developed a decision-analytic model to assess the effectiveness and costs of dapsone, trimethoprim-sulfamethoxazole, or aerosolized pentamidine as initial prophylaxis for pneumocystis carinii pneumonia in human immunodeficiency virus-infected people without prior symptoms aids and with cd4 counts less than 200/mm3. each strategy increased life expectancy by about 18% compared with no prophylaxis; annual per-person costs were $440, $700, and $1,680 for dapsone, trimethoprim-sulfamethoxazole, a ...19911673157
unexplained cd4-positive t-cell deficiency in non-hiv patients presenting as a pneumocystis carinii pneumonia.three cases of pneumocystis carinii pneumonia occurring in adults with unexplained t-cell defects are reported. no hiv markers were found during the follow up, and neither was any immunosuppressive disease. the authors emphasize the possibility that pneumocystis pneumonia may occur and may be treated successfully in previously healthy subjects.19911673634
effect of prophylaxis against pneumocystis carinii on toxoplasma encephalitis. 19911673776
low-dose co-trimoxazole, aerosolised pentamidine, or dapsone plus pyrimethamine for prevention of pneumocystis carinii pneumonia. 19911674036
prophylaxis against pneumocystis carinii pneumonia in children infected with hiv. 19911674037
dna amplification on induced sputum samples for diagnosis of pneumocystis carinii pneumonia.dna amplification and silver staining were used to identify pneumocystis carinii in bronchoscopic lavage and induced sputum samples during 51 episodes of respiratory illness in 47 subjects with hiv infection. in 20 episodes, in which the clinical diagnosis was pneumocystis pneumonia (pcp), silver stain was positive in 14 lavage samples (70%) and 7 sputum samples (35%), whereas dna amplification was positive in 19 lavage samples (95%) and 18 sputum samples (90%). dna amplification was positive in ...19911674765
prophylaxis and treatment of pneumocystis carinii pneumonia.although pneumocystis carinii pneumonia (pcp) can occur in any patient with severe impairment of immunity, there has been a sharp rise in incidence with the spread of human immunodeficiency virus through the usa and western europe, where nearly 80% of patients with hiv infection have at least one episode of pcp during their lifetime (murray et al, 1984).19911676607
effect of zidovudine and pneumocystis carinii pneumonia prophylaxis on progression of hiv-1 infection to aids. the multicenter aids cohort study.although used widely, the effectiveness of zidovudine therapy and primary prophylaxis for pneumocystis carinii pneumonia (pcp) in hiv-1-infected individuals, has not been assessed in a large cohort. we have done an observational study between october, 1986, and october, 1990, of a cohort of 2145 hiv-1-seropositive men and 371 who seroconverted during the study. a markov chain transitional analysis was used to examine the effect of zidovudine and pcp prophylaxis on the probability of progression ...19911677108
predictive value of cd4 lymphocyte numbers for the development of opportunistic infections and malignancies in hiv-infected persons.infection with the human immunodeficiency virus (hiv) results in progressive depletion of the cd4 subset t-lymphocytes and the development of opportunistic infections and certain malignancies. charts were reviewed for 185 hiv-infected individuals with 265 aids-defining illnesses (adis) who had t-lymphocyte subset analyses performed within 2 months prior to or 1 month following the diagnosis. also included were 22 hiv-infected patients with oral candidiasis and 20 with asymptomatic infection. sig ...19911677419
predicting risk of pneumocystis carinii pneumonia in human immunodeficiency virus-infected children.effective prophylaxis exists against pneumocystis carinii pneumonia, a major cause of illness and death among human immunodeficiency virus-infected children and adults. while adults with cd4 counts less than 0.2 x 10(9)/l are at highest risk for pneumocystis carinii, clinical or laboratory markers of high risk in children infected with the human immunodeficiency virus have not yet been established. a chart review of 13 infants with perinatally acquired human immunodeficiency virus infection and ...19911677526
primary care intervention and management for adults with early hiv infection.recent clinical drug trials have demonstrated that early intervention with zidovudine will delay disease progression in asymptomatic or minimally symptomatic hiv-infected individuals. these trials will encourage larger numbers of seropositive persons to seek access to primary care, overloading specialized clinics for aids and hiv care. the care of early hiv-infected individuals will need to be delivered by mainstream primary care providers. this article discusses the initiation and management of ...19911677748
repeated dna in pneumocystis carinii.a 16-kb dna fragment designated rp3-1 and cloned from the genome of rat-derived pneumocystis carinii was found to contain sequences that were repeated approximately 70 times per genome. the repeated sequences in rp3-1 spanned at least 10.4 kb. sequences in rp3-1 were present on each of the 16 p. carinii chromosomes resolved by field inversion gel electrophoresis. most of the p. carinii genomic sequences homologous to those in the rp3-1 clone appeared to be as long as those in the rp3-1 clone but ...19911677941
inflammatory responses to pneumocystis carinii in mice selectively depleted of helper t lymphocytes.pneumocystis carinii is the most important pulmonary pathogen in patients with the acquired immunodeficiency syndrome, but host defenses against p. carinii are not well characterized. we recently reported an experimental model of p. carinii infection, in which mice selectively depleted of cd4+ lymphocytes develop pulmonary infection after inoculation with p. carinii. in the current study, we compared lung inflammatory responses to p. carinii inoculation in cd4-depleted mice and in normal mice in ...19911679991
pneumocystis carinii pneumonia and high-dose dexamethasone to prevent emesis of chemotherapy. 19911681289
[purpura fulminans and c7 deficiency complicated by pneumocystis carinii pneumonia].a case of meningococcal purpura fulminans is reported in a 22-year-old woman who also suffered from a congenital deficiency in the seventh component of the complement system. this was her third episode of recurrent meningitis. in the course of her treatment in intensive care, the septic shock was cured, but she developed pneumocystis carinii pneumonia. histological investigations revealed abnormalities in her t-cell population, with a very low t-helper (cd4) to t-suppressor (cd8) ratio. laborato ...19911681768
the selective toxicity of medications used in the treatment of aids on the cem human leukemic cd4+ t-cell line.eleven medications used in the treatment of the human immunodeficiency virus or subsequent opportunistic infections were tested to determine their toxicity to the growth of the cem line of transformed cd4+ t-cells. a selectivity ratio (ic50/ec50) for each agent against its target pathogen was calculated as an in vitro indication of the therapeutic value of that agent. among the anti-hiv agents tested in this study, 2',3'-dideoxyinosine (ddi) had the highest in vitro selectivity ratio, 2.5 times ...19911682133
reduction in intensity of pneumocystis carinii pneumonia in mice by aerosol administration of gamma interferon.pneumocystis carinii pneumonia in patients with aids may result from impaired local release of gamma interferon from lung lymphocytes and subsequent failure of macrophage activation. we tested this hypothesis with mice rendered immunodeficient by selective depletion of cd4+ lymphocytes and inoculated intratracheally with p. carinii. after aerosol administration of recombinant murine gamma interferon, the intensity of p. carinii infection in these mice was reduced in comparison with that in mice ...19911682252
natural history of disseminated mycobacterium avium complex infection in aids.this study sought to better characterize the natural history of aids-associated disseminated mycobacterium avium complex (mac) infection. towards that end two retrospective studies were done: a case-control survival study and a mac respiratory colonization study. among 137 consecutive patients who had a sterile body site cultured for mycobacteria within 3 months of their first aids-defining episode of pneumocystis carinii pneumonia, median survival was significantly shorter in those with dissemi ...19911682396
application of atp measurement to evaluation of the growth of parasitic protozoa in vitro with a special reference to pneumocystis carinii.1. there was a significant correlation between the increase in the number of entamoeba histolytica, trichomonas vaginalis, giardia lamblia and leishmania donovani in culture, and their atp contents determined by luciferase reaction. 2. the similar correlation was also demonstrated between the decreased number of e. histolytica in the presence of an anti-amebic quassinoid and the nucleotide content in vitro. 3. in the case of pneumocystis carinii, the numbers of the organism remained relatively c ...19911685366
t cells are not sufficient for resistance to pneumocystis carinii pneumonia in mice.severe combined immunodeficient (scid) mice given spleen cells from immunocompetent donors resolve their pre-existing pneumocystis carinii pneumonia (pcp). however, scid mice given infusions of thymus cells or spleen cells depleted of cells positive for either immunoglobulin or immune response-associated antigen did not resolve their pcp. immunofluorescence staining and mitogen responses of spleen cells from the recipient scid mice confirmed that all groups of mice contained functional t cells b ...19911687826
trimethoprim-sulfamethoxazole oral desensitization in hemophiliacs infected with human immunodeficiency virus with a history of hypersensitivity reactions.hemophiliacs infected with human immunodeficiency virus with a history of hypersensitivity reaction to a combination product of trimethoprim and sulfamethoxazole were desensitized orally. six of the seven patients included in the study successfully completed the desensitization protocol and received trimethoprim-sulfamethoxazole for 5 to 7 months after desensitization (mean length of treatment, 5.7 months) for prophylaxis of pneumocystis carinii pneumonia. the small number of patients and the sh ...19911688295
pharmacokinetics of intravenous pentamidine in patients with normal renal function or receiving hemodialysis.the pharmacokinetics of intravenous pentamidine were studied in 10 patients with normal renal function (group 1), 9 volunteer subjects without pneumocystis carinii pneumonia who were receiving maintenance hemodialysis (group 2), and 5 patients with normal or mildly abnormal renal function (group 3) after the last dose of therapy. the concentration-time data were best represented by a three-compartment model. the peak plasma concentration, plasma clearance, and elimination half-life ranged from 2 ...19911984463
pneumocystis carinii pneumonia. rare cause of hemoptysis.pneumocystis carinii pneumonia is a frequent manifestation of the acquired immunodeficiency syndrome (aids). it commonly presents with nonproductive cough, fever, and dyspnea. we report this case of p carinii pneumonia presenting with hemoptysis, since to the best of our knowledge, hemoptysis has not been reported to be a presenting manifestation of p carinii pneumonia. autopsy revealed multiple lung cavities.19911984969
purification and characterization of a major human pneumocystis carinii surface antigen.previous studies of pneumocystis carinii have identified the major surface antigen of rat and human isolates as proteins of 116,000 and 95,000 mol wt, respectively, that are antigenically not identical. in this study both rat and human p. carinii proteins were purified by solubilization with zymolyase followed by molecular sieve and ion exchange chromatography. the native proteins had an apparent mol wt of 290,000 or greater, based on molecular sieve studies as well as cross-linking studies. bot ...19911985093
a cluster of pneumocystis carinii pneumonia in adults without predisposing illnesses. 19911985246
pneumocystis carinii--new clinical spectrum? 19911985248
pneumocystis carinii choroiditis after long-term aerosolized pentamidine therapy. 19911985481
risk stratification of ambulatory patients suspected of pneumocystis pneumonia.to determine whether aspects of clinical history, physical examination, and laboratory studies improve the diagnostic accuracy of the chest roentgenogram in the diagnosis of pneumocystis carinii pneumonia (pcp), we followed up 302 consecutive patients with respiratory symptoms and risk factors for human immunodeficiency virus. of the 279 patients (92%) with follow-up information available, 31 (11%) were diagnosed with pcp. only 68% of patients with pcp had typical chest roentgenograms. regressio ...19911985585
practical utility of lactate dehydrogenase in the diagnosis of human immunodeficiency virus-related pneumocystis carinii pneumonia. 19911985599
disseminated pneumocystis carinii infection with hepatic involvement in a patient with the acquired immune deficiency syndrome.extrapulmonary infection with pneumocystis carinii (p. carinii) in aids patients is uncommon, and is often described only at postmortem examination. although most antemortem cases involve spread to the bone marrow or spleen, p. carinii involvement of other organs has only recently been described. despite the frequency of liver enzyme abnormalities in aids patients with a history of p. carinii pneumonia, p. carinii has been observed only rarely in the liver. we present a well-documented case of p ...19911986558
survival differences in patients with aids.to define the clinical, demographic, and behavioral variables that may influence survival in patients with aids, we studied 526 patients with aids diagnosed through september 1987 who were cared for at a single medical center. a diversity of racial and ethnic backgrounds, ages, both men and women, and all risk behaviors except hemophilia were well represented. the initial aids defining diagnosis was the most powerful predictor of survival. the median survival was 12.8 months for patients present ...19911987352
pneumocystis carinii infections in hiv-infected children.since 1981, 1200 children with acquired immunodeficiency syndrome have been reported to the centers for disease control. among these children, pneumocystis carinii has been the leading cause of serious morbidity and mortality. this review discusses the epidemiology, diagnosis, and treatment of p. carinii.19911987519
extrapulmonary pneumocystis carinii infection: another cause of splenic "bull's-eye" lesions. 19911987634
widespread dissemination of pneumocystis carinii infection in a patient with acquired immune deficiency syndrome receiving long-term treatment with aerosolized pentamidine.patients with acquired immune deficiency syndrome (aids) may be infected with many opportunistic pathogens, the most common of which is pneumocystis carinii. p. carinii infection typically presents as a subacute pneumonia. however, rare cases of localized, extrapulmonary, and disseminated disease have been described. standard therapy for p. carinii is systemically administered trimethoprim-sulfamethoxazole or pentamidine. these agents, however, frequently are associated with serious adverse effe ...19911987758
spontaneous pneumothorax in aids patients with recurrent pneumocystis carinii pneumonia despite aerosolized pentamidine prophylaxis.aerosolized pentamidine prophylaxis for pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome (aids) may predispose these patients to recurrent apical pneumocystis infection. bullous changes and pulmonary cysts develop in the lung apices due to repeated episodes of inflammation and cytotoxic effects of hiv on pulmonary macrophages. these changes progress despite prophylaxis against recurrent pneumocystis infection with aerosolized pentamidine, increasing the risk ...19911989819
[pneumocystis carinii pneumonia in patients with a severe combined immunodeficiency].we describe three patients with pneumocystis carinii pneumonia as the initial presentation of severe combined immunodeficiency disease. the pneumonia in the first patient was treated successfully with trimethoprim/sulphamethoxazole (tmp/smz). the second patient died despite therapy with tmp/smz and pentamidine. the third patient failed to respond to therapy with tmp/smz and pentamidine. he was subsequently treated with trimetrexate and leucovorin. treatment with the new folic acid antagonist tri ...19911990300
cavitary pneumocystis carinii pneumonia in patients receiving aerosol pentamidine prophylaxis.we have described two patients with aids who had cavitary pneumocystis carinii pneumonia while receiving aerosolized pentamidine prophylaxis. this is the first report of this complication. neither patient showed a clinical response to subsequent use of pentamidine either intravenously or by aerosol followed by intravenous use. clinicians should be aware of the possibility that cavitary pneumonia in patients receiving aerosolized pentamidine may be due to p carinii.19911990469
an evaluation of the use of the statewide planning and research cooperative system of new york state as a resource planning tool for hiv infection.hospital discharge records of patients with pneumocystis carinii pneumonia (pcp) in new york state were studied to determine whether cases of human immunodeficiency virus (hiv) infection were identified. we estimate that as many as 13 percent of hospitalizations of patients with pcp in 1987 and 10 percent of those in 1988 were not appropriately identified as hiv related. identification of pcp as hiv related was a function of a hospital's volume of pcp admissions.19911990864
survival trends of people with aids in washington state.survival rates of 609 cases of acquired immunodeficiency syndrome (aids) in washington state diagnosed between 1982 and 1987 according to pre-1987 aids surveillance definition were analyzed. people with a primary diagnosis of kaposi's sarcoma survived longer than those with pneumocystis carinii pneumonia. both groups survived longer than those with other diagnoses. median survival increased from 11.3, to 12.5, to 20.8 months for cases diagnosed in or before 1985, during 1986, and during 1987, re ...19911990865
pneumocystis carinii pneumonia and respiratory failure in aids. improved outcomes and increased use of intensive care units.to determine whether the outcome of intensive care for patients with aids, pneumocystis carinii pneumonia (pcp), and respiratory failure has changed, we studied patients admitted to the intensive care units an san francisco general hospital from 1981 to 1988. we compared the course of patients with pcp and respiratory failure admitted to the intensive care unit from 1986 to 1988 with a similar cohort hospitalized from 1981 to 1985. the hospital survival rate for the 35 patients in the 1986 to 19 ...19911990936
dapsone as a single agent is suboptimal therapy for pneumocystis carinii pneumonia.in a prospective, noncomparative study, seven patients with mild pneumocystis carinii pneumonia, characterized by room air arterial po2 greater than 60 mm hg at the time of presentation, were treated with dapsone alone at a dose of 200 mg daily. two of the seven patients required mechanical ventilation for respiratory failure on day 5 of dapsone therapy; both died. four patients experienced major side effects during dapsone therapy. none of the seven patients successfully completed a full course ...19911992102
lack of benefit of methotrexate in severe, steroid-dependent asthma. a double-blind, placebo-controlled study.to determine the effect of low-dose methotrexate in asthmatic patients on steroid use, asthma symptom scores, pulmonary function, airway reactivity, blood cellular components, and immunoglobulin e levels.19911992876
[glucocorticoids in aids-associated pneumocystis carinii pneumonia]. 19911993439
pneumothorax in aids.to determine risk factors for the development of pneumothorax in patients with the acquired immunodeficiency syndrome (aids).19911994791
pulmonary tolerance of prophylactic aerosolized pentamidine in human immunodeficiency virus-infected patients.the effects of primary and secondary long-term prophylaxis of pneumocystis carinii pneumonia with aerosolized pentamidine on pulmonary function in hiv+ patients were evaluated. eighty-one patients, none of whom were drug addicts or had pulmonary kaposi's sarcoma, were studied. fifty patients were receiving ap as secondary prophylaxis, 36 monthly and 14 twice-monthly; eight patients with a history of pcp served as control subjects. twenty-three patients were receiving ap as primary prophylaxis, 1 ...19911995216
pneumocystis carinii pneumonia complicating multiple myeloma.pneumocystis carinii pneumonia complicated the course of two patients with multiple myeloma. the diagnosis was established in both cases by bronchoalveolar lavage, which demonstrated the typical pneumocysts. clinical and roentgenographic improvement in both patients was observed following a course of trimethoprim-sulfamethoxazole. one patient had lymphocyte subsets performed with a cd4/cd8 ratio of 0.8; both patients were hiv antibody-negative by elisa. both patients tolerated prophylactic tmp-s ...19911995221
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