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Pneumocystis carinii pneumonia. Diagnosis by lung biopsy
Abstract:
Pneumocystis carinii pneumonia was suspected in 52 patients who underwent lung biopsy for diagnosis of diffuse pulmonary infiltrates. All but five of the procedures were limited thoracotomies. There were no instances of significant postoperative hemorrage or of pneumothorax compromising ventilation. The diagnosis of P. carinii pneumonia was made rapidly from imprints of the lung stained by the Gram-Weigert method in the 18 patients who had P. carinii pneumonia. Over-all, the rate of recovery from Pneumocystis pneumonia after treatment with pentamidine isethionate was 41 percent. However, among patients with no other pulmonary lesion (group A), the survival rate was 58 per cent; none of the patients with coexisting pulmonary disease (group B) recovered. The pulmonary infiltrates in the other 32 patients represented a variety of processes, of which 5 were fungal infections and 5 were due to lymphoma. Fifteen patients had an organizing interstitial and intraalveolar pneumonia of undertermined origin.
Insights
Diagnosing Pneumocystis pneumonia via lung biopsy showed rapid results with Gram-Weigert staining. Survival rates varied, with 58% of patients without other lung issues recovering after pentamidine isethionate treatment.
Area of Science:
- Pulmonology
- Infectious Diseases
- Medical Diagnostics
Background:
- Diffuse pulmonary infiltrates necessitate accurate diagnosis.
- Pneumocystis pneumonia (PCP) is a significant opportunistic infection.
Purpose of the Study:
- To evaluate the diagnostic utility of lung biopsy for PCP.
- To assess treatment outcomes for PCP with pentamidine isethionate.
Main Methods:
- Limited thoracotomies were performed on 52 patients with diffuse pulmonary infiltrates.
- Lung imprints were stained using the Gram-Weigert method for rapid diagnosis.
- Patient outcomes were analyzed based on the presence of coexisting pulmonary disease.
Main Results:
- Pneumocystis pneumonia was diagnosed in 18 patients.
- Gram-Weigert staining provided rapid diagnostic results.
- Overall survival with pentamidine isethionate treatment was 41%.
- Patients without other pulmonary lesions (Group A) had a 58% survival rate.
- No patients with coexisting pulmonary disease (Group B) recovered.
- Other diagnoses included fungal infections, lymphoma, and undetermined pneumonia.
Conclusions:
- Lung biopsy with Gram-Weigert staining is an effective method for diagnosing PCP.
- Pentamidine isethionate treatment efficacy is influenced by the presence of other pulmonary conditions.
- Coexisting pulmonary disease significantly impacts PCP patient prognosis.