Related Experiment Videos
Pneumocystis carinii pleural effusion. Pathogenesis and pleural fluid analysis
M L Horowitz1, M Schiff, J Samuels
1Department of Medicine, North Shore University Hospital, Manhasset, NY 11030.
The American Review of Respiratory Disease
|July 1, 1993
Summary
Pneumocystis carinii in pleural effusions is rare in AIDS patients, but diagnosis is possible with specific stains. This condition may extend from underlying Pneumocystis pneumonia and has a similar prognosis.
Area of Science:
- Infectious Diseases
- Pulmonology
- Critical Care Medicine
Background:
- Pneumocystis carinii pneumonia (PCP) is a common opportunistic infection in patients with Acquired Immunodeficiency Syndrome (AIDS).
- Pleural effusions are an uncommon manifestation of PCP.
Observation:
- Three new cases of Pneumocystis carinii in pleural effusions of patients with AIDS are presented, bringing the total reported cases to six.
- Diagnosis was confirmed by visualizing Pneumocystis in pleural fluid using Gomori methenamine silver stain.
- Elevated LDH levels (>400) and a pleural fluid to serum LDH ratio (>1.0) were noted in all presented cases.
Findings:
- All six reported patients had a history of aerosolized pentamidine use.
- Five of the six patients had documented underlying Pneumocystis pneumonia.
- One patient presented with primary pleural infection, suggesting Pneumocystis pleural disease may be an extension of subpleural pneumonia.
Implications:
- Pneumocystis pleural disease is likely an extension of subclinical or smoldering Pneumocystis pneumonia.
- The prognosis for Pneumocystis pleural disease appears to be similar to that of Pneumocystis pneumonia alone.
- Early diagnosis and recognition of this rare manifestation are crucial for appropriate patient management.