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[Pneumocystis carinii: an optic and electron microscopy study in samplings of 16 cases]
1Departamento de Anatomía Patológica, Hospital Clínico de la P Universidad Católica de Chile, Santiago.
Abstract:
Sixteen patients with P. carinii infection were studied between 1977 and 1989; 12 were male and the age ranged from 4 months to 53 years old. 19 samples, 5 from autopsy, 7 from biopsy and 7 cytological aspirates were stained with hematoxylin-eosin, Gomori-Grocott, Giemsa and 0 toluidine. Autopsy material was studied by transmission electron microscopy. The diagnosis was made premortem in 11 patients. AIDS was the underlying disease in 6 patients, the rest having other immunodepressant conditions. P. carinii infection was limited to the lung in all patients. The Gomori Grocott stain gave positive results in all cases; cytological studies were generally noncontributory. Opportunistic agents were found in 4 patients (aspergillus, cytomegalovirus and C. neoformans).
Insights
Pneumocystis carinii pneumonia (PCP) diagnosis in immunocompromised patients was evaluated. The Gomori Grocott stain proved highly effective for diagnosing PCP, especially in lung tissue samples.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Diagnostic Pathology
Context:
- Pneumocystis carinii pneumonia (PCP) is a significant opportunistic infection in immunocompromised individuals.
- Early and accurate diagnosis is crucial for effective treatment and improved patient outcomes.
- This study retrospectively analyzed cases of PCP diagnosed between 1977 and 1989.
Purpose:
- To evaluate diagnostic methods for Pneumocystis carinii infection.
- To assess the efficacy of various staining techniques, including Gomori Grocott, hematoxylin-eosin, Giemsa, and toluidine blue.
- To determine the diagnostic yield of different sample types (autopsy, biopsy, cytological aspirates) and transmission electron microscopy.
Summary:
- Sixteen patients with P. carinii infection were studied, with a focus on diagnostic methods.
- The Gomori Grocott stain demonstrated 100% positivity in all cases.
- Cytological studies were generally noncontributory, while transmission electron microscopy was used for autopsy material.
- P. carinii infection was confined to the lungs in all patients, often occurring in individuals with Acquired Immunodeficiency Syndrome (AIDS) or other immunosuppressive conditions.
- Concurrent opportunistic infections, such as aspergillus, cytomegalovirus, and Cryptococcus neoformans, were identified in a subset of patients.
Impact:
- Highlights the superior diagnostic performance of the Gomori Grocott stain for P. carinii.
- Underscores the limitations of cytological aspirates for PCP diagnosis.
- Provides insights into the clinical presentation and associated opportunistic infections in PCP patients during the specified period.