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Objective:To explore the clinical characteristics of pneumocystis carinii pneumonia (PCP) after kidney transplantation.Methods:From January 2020 to January 2022, clinical data were retrospectively reviewed for 13 renal transplant recipients with pneumocystis pneumonia diagnosed by metagenomics next generation sequencing (mNGS). There were 3 females and 10 males with an age range of (46±10) years.The median time of postoperative onset was 10(2-21) months; The major clinical manifestations included fever ( n=11), cough ( n=7), expectoration ( n=6) and dyspnea ( n=11). Paired t-test was employed for analyzing the laboratory results at admission and discharge. Results:The diagnosis was confirmed by the detection of NGS in alveolar lavage fluid or venous blood.The levels of G test, LDH test, total T lymphocyte absolute count (CD3+ Abs), inhibitory/cytotoxic T lymphocyte count (CD3+ CD8+ Abs) and auxiliary/induced T lymphocyte absolute count (CD3+ CD4+ Abs) were (543.27±440.49) pg/ml, (529.98±222.43)U/L and (191.92±119.42)/μl, (87.33±50.59)/μl and (106.92±87.42)/μl at admission and (69.58±50.21) pg/ml, (285.38±46.62 U/L), (888.58±672.99)/μl, (336.83±305.21)/μl and (520.08±388.76)/μl at discharge.The differences were statistically significant ( P<0.001, P=0.002, 0.006, 0.017, 0.005). All of them received compound sulfamethoxazole and caspofungin.Except for one death due to septic shock after 21-day treatment, 12 cases were cured. Conclusions:mNGS test is one of the important tool for an early diagnosis of PCP.Combined use of compound sulfamethoxazole and caspofungin is an effective anti-infective regimen.And immune function monitoring is vital for adjusting antibiotic and immunosuppressive regimens.
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Objective:To explore the nursing points of pneumocystis carinii pneumonia after liver transplantation in infants.Methods:Strengthened artificial airway management for children to improve dyspnea. Adopted nasal high-flow humidifying oxygen therapy to correct hypoxemia. Implemented individual temperature management to effectively control high fever. Strengthened children′s medication management, predictive skin management, using the protective isolation and psychological nursing.Results:After timely treatment and careful nursing, the condition of the three children was improved, SpO 2 was maintained at 0.95-1.00, and the patients were discharged successfully. One patient with respiratory failure died of multiple organ failure due to the deterioration of the condition after receiving extracorporeal membrane oxygen and supportive treatment. Conclusions:The infants with pneumocystis carinii pneumonia after liver transplantation should strengthen airway management, correct hypoxia. At the same time to do a good job of symptomatic care, strengthen the observation of the condition, can promote the rehabilitation.
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Objective:To explore the value of detecting pneumocystis carini(PC)rapidly in immunocompromised patients by loop mediated isothermal amplification(LAMP).Methods:Respiratory tract specimens of immunocompromised children suspected of pneumocystis carinii pneumonia(PCP) at Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiao Tong University were collected from May 2020 to May 2021.PCR and LAMP methods were used to detect PC.Firstly, LAMP primers of PC were synthetized according to the conserved region of PC gene, and the LAMP reaction system and reaction conditions were optimized to evaluate the sensitivity and specificity.Then, the results of pathogens were compared with those of PCR detection.Results:The established LAMP detection technology for PC had high specificity and super sensitivity.The detection results could be obtained within 1 hour.In 12 clinical samples, 10 cases were positive and 2 cases were negative, the coincidence rate of LAMP and PCR technique was 100%.Conclusion:LAMP can detect PC more rapidly and sensitively than PCR, and it can provide a good support for clinical rapid diagnosis of PCP.
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Objective:To analyze the clinical characteristics and risk factors for mortality of severe pneumocystis carinii pneumonia(PCP)in pediatric liver transplant(LT)recipients.Methods:The data of severe PCP in LT recipients diagnosed at Shanghai Children′s Medical Center from November 2019 to February 2021 were collected.The clinical characteristics and risk factors for 28-day mortality were analyzed.Results:Fifteen patients were enrolled in the study.Thirteen cases survived and 2 cases were non-survived.There was no routine anti-pneumocystis prophylaxis after LT.The median age of onset of PCP was 12(7, 26)months.The median time after LT was 3.00(0.33, 4.00)months.The onset clustered in November-December and June-August.All patients were mechanically ventilated, and some patients were given prone ventilation(11 cases), neuromuscular blocking agents(13 cases)and high concentration oxygen(more than 60%, nine cases). Fourteen cases were complicated with other infections.Two cases were complicated with pneumothorax and subcutaneous/mediastinal emphysema.There were 2 cases with septic shock-like manifestation, 1 case of right heart insufficiency, 1 case of right heart failure(death), and 1 case of multiple organ failure(death). Compared with the survived group, the non-survived group had higher pediatric risk of mortality Ⅲ score[3.5(0.0, 6.0)vs.8.5(5.0, 12.0), Z=1.993, P=0.046] and lactate dehydrogenase level[1 731.5(1 012.0, 3 270.0)U/L vs.4 387.5(3 606.0, 5 169.0)U/L, Z=2.148, P=0.032]. Conclusion:PCP in pediatric LT is critical and complicated.Pediatric risk of mortality Ⅲ scores and lactate dehydrogenase increase in 28-day hospitalized deaths.
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Objective:To investigate the clinical characteristics and prognosis factors in children with pneumocystis carinii pneumonia (PCP) without human immunodeficiency virus (HIV) infected.Methods:From January 2017 to December 2020, 35 non-HIV infected patients with PCP were admitted to Hunan Children′s Hospital.According to the prognosis at discharge, they were divided into survival group and death group.The clinical characteristics of two groups were compared, and the prognostic factors were analyzed.Results:The age of 35 patients ranged from 1 month to 15 years, including 24 males and 11 females.Seven patients(20.0%) had primary immunodeficiency, 5 patients(14.2%) had autoimmune disease, and 4 patients(11.4%) had renal disease.Eighteen patients were treated with long-term hormone and 13 patients were treated with immunosuppressive agents before the onset of the disease.Clinical symptoms included shortness of breath or dyspnea, cough, fever and so on, while with few pulmonary signs.Peripheral blood lymphocyte count was less than 1.5×10 9/L in 18 cases.The median LDH was(654.94±57.66)U/L; Fungal D-glucan increased in 13 cases.The median P/F was(121.29±23.25)mmHg, and P/F was less than 200 mmHg in 16 cases.CD4 cells were less than 500/μL in 15 cases and less than 200/μL in 8 cases.The imaging findings were mainly consolidation or patellar shadow, diffuse ground glass shadow, 3 cases with pleural effusion, and 1 case with pneumothorax.Twenty-two cases survived and 13 died, with a mortality rate of 37.1%.There were statistically significant differences in hospitalization days, CD4 cell count, Fungal D-glucan, P/F, ICU admission and invasive mechanical ventilation between two groups( P<0.05). Logistic multivariate analysis showed that decreased P/F value was an independent risk factor affecting the prognosis of non-HIV infected children with PCP ( OR=0.006, 95% CI 0.975-1.000). Conclusion:The clinical manifestations, laboratory examinations and imaging examinations of non-HIV infected patients with PCP lack specificity.When a diagnosis is suspected, high-resolution CT should be performed based on the results of peripheral blood lymphocyte count, CD4 cell count, fungal D, LDH, and blood gas analysis results as soon as possible, compound sulfamethoxazole should be used timely.Decreased P/F value is an independent factor affecting the prognosis of non-HIV children with PCP.
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Objective:To explore the value of detecting pneumocystis carini(PC)rapidly in immunocompromised patients by loop mediated isothermal amplification(LAMP).Methods:Respiratory tract specimens of immunocompromised children suspected of pneumocystis carinii pneumonia(PCP) at Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiao Tong University were collected from May 2020 to May 2021.PCR and LAMP methods were used to detect PC.Firstly, LAMP primers of PC were synthetized according to the conserved region of PC gene, and the LAMP reaction system and reaction conditions were optimized to evaluate the sensitivity and specificity.Then, the results of pathogens were compared with those of PCR detection.Results:The established LAMP detection technology for PC had high specificity and super sensitivity.The detection results could be obtained within 1 hour.In 12 clinical samples, 10 cases were positive and 2 cases were negative, the coincidence rate of LAMP and PCR technique was 100%.Conclusion:LAMP can detect PC more rapidly and sensitively than PCR, and it can provide a good support for clinical rapid diagnosis of PCP.
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Objective:To analyze the clinical characteristics and risk factors for mortality of severe pneumocystis carinii pneumonia(PCP)in pediatric liver transplant(LT)recipients.Methods:The data of severe PCP in LT recipients diagnosed at Shanghai Children′s Medical Center from November 2019 to February 2021 were collected.The clinical characteristics and risk factors for 28-day mortality were analyzed.Results:Fifteen patients were enrolled in the study.Thirteen cases survived and 2 cases were non-survived.There was no routine anti-pneumocystis prophylaxis after LT.The median age of onset of PCP was 12(7, 26)months.The median time after LT was 3.00(0.33, 4.00)months.The onset clustered in November-December and June-August.All patients were mechanically ventilated, and some patients were given prone ventilation(11 cases), neuromuscular blocking agents(13 cases)and high concentration oxygen(more than 60%, nine cases). Fourteen cases were complicated with other infections.Two cases were complicated with pneumothorax and subcutaneous/mediastinal emphysema.There were 2 cases with septic shock-like manifestation, 1 case of right heart insufficiency, 1 case of right heart failure(death), and 1 case of multiple organ failure(death). Compared with the survived group, the non-survived group had higher pediatric risk of mortality Ⅲ score[3.5(0.0, 6.0)vs.8.5(5.0, 12.0), Z=1.993, P=0.046] and lactate dehydrogenase level[1 731.5(1 012.0, 3 270.0)U/L vs.4 387.5(3 606.0, 5 169.0)U/L, Z=2.148, P=0.032]. Conclusion:PCP in pediatric LT is critical and complicated.Pediatric risk of mortality Ⅲ scores and lactate dehydrogenase increase in 28-day hospitalized deaths.
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Objective:To investigate the clinical characteristics and prognosis factors in children with pneumocystis carinii pneumonia (PCP) without human immunodeficiency virus (HIV) infected.Methods:From January 2017 to December 2020, 35 non-HIV infected patients with PCP were admitted to Hunan Children′s Hospital.According to the prognosis at discharge, they were divided into survival group and death group.The clinical characteristics of two groups were compared, and the prognostic factors were analyzed.Results:The age of 35 patients ranged from 1 month to 15 years, including 24 males and 11 females.Seven patients(20.0%) had primary immunodeficiency, 5 patients(14.2%) had autoimmune disease, and 4 patients(11.4%) had renal disease.Eighteen patients were treated with long-term hormone and 13 patients were treated with immunosuppressive agents before the onset of the disease.Clinical symptoms included shortness of breath or dyspnea, cough, fever and so on, while with few pulmonary signs.Peripheral blood lymphocyte count was less than 1.5×10 9/L in 18 cases.The median LDH was(654.94±57.66)U/L; Fungal D-glucan increased in 13 cases.The median P/F was(121.29±23.25)mmHg, and P/F was less than 200 mmHg in 16 cases.CD4 cells were less than 500/μL in 15 cases and less than 200/μL in 8 cases.The imaging findings were mainly consolidation or patellar shadow, diffuse ground glass shadow, 3 cases with pleural effusion, and 1 case with pneumothorax.Twenty-two cases survived and 13 died, with a mortality rate of 37.1%.There were statistically significant differences in hospitalization days, CD4 cell count, Fungal D-glucan, P/F, ICU admission and invasive mechanical ventilation between two groups( P<0.05). Logistic multivariate analysis showed that decreased P/F value was an independent risk factor affecting the prognosis of non-HIV infected children with PCP ( OR=0.006, 95% CI 0.975-1.000). Conclusion:The clinical manifestations, laboratory examinations and imaging examinations of non-HIV infected patients with PCP lack specificity.When a diagnosis is suspected, high-resolution CT should be performed based on the results of peripheral blood lymphocyte count, CD4 cell count, fungal D, LDH, and blood gas analysis results as soon as possible, compound sulfamethoxazole should be used timely.Decreased P/F value is an independent factor affecting the prognosis of non-HIV children with PCP.
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Pneumocystis Carinii Pneumonia (PCP) and Pulmonary Tuberculosis (PTB) are the most frequent Opportunistic Infection (OI) in People living with HIV/AIDS (PLWHA), especially whose CD4 counts<200 cells/mL. There is no pathognomonic sign and symptom of pneumocystis, radiographic imaging (chest radiograph) and blood examination. An intractable microorganism cannot be isolated or sustained in culture. The diagnosis of PCP is complicated, based on the presumptive diagnosis. PCP should be treated optimally as soon as possible in order not to be fatal. We report a complicated case of a female 26 y-old, diagnosed with HIV infection on Highly Active Anti Retro Viral Therapy (HAART), PTB on Anti Tuberculosis Drugs (ATD) concurrent with PCP. She also has a history of various Drug Hypersensitivity Reactions (DHR) include Rifampycin, Ciprofloxacin and Cotrimoxazole. DHR is unpredictable, and Clindamycin and Primaquin are the recommended alternative drugs for PCP, the strategic therapy is by Desensitization Protocols.
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Objective: To analyze the clinical]features of the patient with nephrotic syndrome who developed Pneumocystis carinii pneumonia (PCP) and cytomegalovirus pneumonia (CMP) after oral administration of tacrolimus caspsules, and to discuss the correlations between immunosuppressive patient and Pneumocystis carinii (Pc) and cytomegalovirus (CMV) infection, and to provide the basis for the reasonable treatment plan in the early stage. Methods: The clinical materials of one patient with nephrotic syndrome who developed PCP and CMP after oral administration of tacrolimus capsules were collected and the clinical symptoms, past medical history and outcomes, auxiliary examination, treatment plan and prognosis were analyzed; the relevant literatures were reviewed. Results: The male 47-year-old patient was admitted to hospital because of cough for 1 month, shortness of breath for 1 week and fever for 3 d. The patient had the history of diabetes mellitus and took the medication regularly , and the level of blood sugar was well controlled. At the beginning of 2018, the patient received renal biopsy due to edema of the lower extremities and was diagnosed as stage II membranous nephropathy accompanying with mild mesangial proliferative diabetic nephropathy; the patient was orally administrated with glucocorticoid. In July 2018, the patient was diagnosed as nephrotic syndrome and stage II membranous nephropathy, and had been orally administrated with tacrolimus capsules after discharge. After admission, the patient developed acute respiratory distress syndrome rapidly; the multiple exudation and nodular foci of both lungs were found on the chest imaging, and the infectious lesions were considered. The IgM antibody and IgG antibody of CMV of the patient were both positive. The high throughput gene detection results of the infection pathogens in blood showed Pneumocystis jiroveci of Pneumocystis and human herpesvirus 5 (HHV-5). PCP complicated with CMP was diagnosed definitively. The patient was treated with sulfamethoxazole combined with ganciclovir and noninvasive ventilation. The patient was discharged after the condition was improved. Conclusion: The patient with low immunity should be alert to the mixed infection of PCP and CMP if he develops rapidly progressive hypoxemia.
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Objective To investigate the feasibility of LAMP detection in Pneumocystis carinii pneumonia rats and the changes of 1, 3-β-D-glucan.Methods 40 Wister rats were randomly divided into control group and lung infection group, 20 rats in each group.Specific primers were designed for pneumoniae carinii and LAMP technique was carried out to identify whether the rats were infected or not.The levels of 1, 3-β-D-glucan in peripheral blood and lung lavage fluid were detected by ELISA.Results Compared with the control group, there were 4 dead rats in the lung infection group, the body weight decreased significantly, and the lung weight and the percentage of the lung volume increased significantly (P＜0.05).LAMP method can detect Pneumocystis carinii, the control group was negative.Compared with the control group, the level of 1, 3-β-D-glucan in peripheral blood and lung lavage fluid in the lung infection group increased.And the 1, 3-β-D-glucan level in lung lavage fluid was higher than that in peripheral blood (P＜0.05).Conclusion In this study, we successfully constructed a rat model of Pneumocystis carinii pneumonia and established a simple and rapid method for LAMP detection of Pneumocystis carinii.1, 3-β-D-glucan and Pneumocystis carinii have some relevance.
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There are no evidence-based guidelines about prophylaxis against Pneumocystis jiroveci pneumonia in inflammatory bowel disease. We report a case of P. jiroveci pneumonia in patient with Crohn's disease receiving infliximab and methotrexate. This case emphasizes the importance of considering the possibility of this infection in inflammatory bowel disease patients treated on biological therapy.
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Humans , Female , Middle Aged , Pneumonia, Pneumocystis/chemically induced , Gastrointestinal Agents/adverse effects , Crohn Disease/drug therapy , Infliximab/adverse effects , Pneumonia, Pneumocystis/diagnostic imaging , Radiography , Tomography, X-Ray Computed , Risk Factors , Immunosuppressive Agents/adverse effectsABSTRACT
In order to increase awareness of infection of Penicillium marneffei combined with Pneumocystis carinii pneu monia,we analysed and discussed the diagnosis and treatment of a P.marneffei combined with Pneumocystis carinii pneumonia and reviewed relevant literaure.Pharynx and larynx P.marneffei infection uozhes logy and molecullar was confirmed by physical examination,sputum culture and biopsy.Pneumocystis carinii pneumonia was diagnosed by CT findings and tested positive by PCR for P.carinii (PC).After antifungal treatment,the patient's symptoms and signs showed significant im provement.In conclusion,to achieve early diagnosis and appropriate treatment,sputum culture,biopsy and chest radiograph are suggested for pharynx and larynx recurrent ulcer which is difficult to heal.
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Objective: To explore the breakthrough points of pharmaceutical care performed by clinical pharmacists for the patients with severe infection.Methods: One case of severe pneumonia patient with Pneumocystis carinii and aspergillosis was treated with pharmaceutical care and intervention, and the effect of anti infection treatment and adverse drug reactions were concerned and individualized dosing regimen were provided.Results: Through the pharmaceutical care for the patient with severe infection, the safety and effectiveness of drug use were ensured.Conclusion: Using the treatment contradictions and adverse drug reactions as the breakthrough points, clinical pharmacists participate in clinical practice to embody their own value.
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OBJECTIVE:To explore the method and role of clinical pharmacists in pharmaceutical care for nephrotic syndrome complicated with Pneumocystis carinii pneumonia (PCP). METHODS:Clinical pharmacists participated in the treatment for a pa-tient with nephrotic syndrome complicated with PCP,and implemented pharmaceutical care in terms of the development of anti-in-fective therapy regimens,glucocorticoid optimization,guardianship for drug use,the medication education for patients. Clinical pharmacists provided suggestion that primary anti-infective plan of azithromycin 0.5 g,ivgtt,qd+Compound sulfalene tablet 2 tab-lets,po,q12 h;which was not effective,was adjusted plan as Compound sulfalene tablet 3 tablets,po,q6 h+clindamycin 0.6 g, ivgtt,q8 h+caspofungin 50 mg,ivgtt,qd. The dose of Methylprednisolone for injection was adjusted 4 times according to disease progression. RESULTS:Physicians adopted the suggestions of clinical pharmacists. After 30 days of treatment, lung abnormal le-sion was absorbed basically and infection control was achieved. CONCLUSIONS:Clinical pharmacists participate in anti-infective treatment and pharmaceutical care,and assist physicians to develop therapy plan to promote rational drug use in the clinic and im-prove the effectiveness and safety of clinical treatment.
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PURPOSE: Pneumocystis jirovecii pneumonia occurs in various immunocompromised patients. Despite the prophylaxis strategies in clinical practice, certain patients develop P. jirovecii pneumonia. This study was performed to investigate pediatric cases with P. jirovecii pneumonia in a single center. METHODS: We identified pediatric patients younger than 19 years with microbiologically confirmed P. jirovecii pneumonia from January 2000 to February 2014. A retrospective chart review was performed. RESULTS: Fifteen episodes of P. jirovecii pneumonia in 14 patients were identified with median age of 8.3 years (range, 0.4-18.6 years). Among these patients, 11 patients had hematology-oncology diseases, 2 had primary immunodeficiency disorders (one with severe combined immunodeficiency and the other with Wiskott Aldrich syndrome), 1 had systemic lupus erythematosus and 1 received kidney transplant. Four patients were transplant recipients; 1 allogeneic and 2 autologous hematopoietic cell transplant and 1 with kidney transplant. The median absolute lymphocyte count at the diagnosis of P. jirovecii pneumonia was 5,156 cells/mm³ (range, 20-5,111 cells/mm³). In 13 episodes (13 of 15, 86.7%), patients were not receiving prophylaxis at the onset of P. jirovecii pneumonia. For treatment, trimethoprim/sulfamethoxazole was given as a main therapeutic agent in all 15 episodes. Steroid was given in 9 episodes (60%). Median treatment duration was 15 days (range, 4-33 days). Overall mortality at 60 days was 35.7% (5 of 14). CONCLUSION: Majority of our patients developed P. jirovecii pneumonia while not on prophylaxis. Continuous efforts and more data are needed to identify high risk patients who may get benefit from P. jirovecii pneumonia prophylaxis.
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Humans , Diagnosis , Immunocompromised Host , Kidney , Lupus Erythematosus, Systemic , Lymphocyte Count , Mortality , Pediatrics , Pneumocystis carinii , Pneumocystis carinii , Pneumocystis , Pneumonia , Retrospective Studies , Severe Combined Immunodeficiency , Transplant Recipients , TransplantsABSTRACT
Objective To analyze the epidemiologic characteristics and risk factors for mortality in non-(human immunodeficiency virus,HIV) infected children with pneumocystis carinii pneumonia(PCP). Methods The data of non-HIV infected children with PCP diagnosed in Beijing Children′s Hospital from January 1,2006 to December 31,2012 were collected. They were divided into survival and non-survival group according to the prognosis. The epidemiologic characteristics and risk factors for mortality were analyzed. Results Sixteen patients were enrolled in this study. Ten of them survived and 6 of them were non-survived. The basic diseases included malignant tumor in 5 patients and non-malignancy diseases in 11 of them. Com-pared with the survival group,the non-survival group had a higher average age [(12. 00 ± 2. 00) years vs. (6. 65 ± 4. 32)years,P=0. 01],higher ratio to need mechanical ventilation (6/6 vs. 4/10,P=0. 04),lower PaO2/FiO2[(73. 88 ±26. 95) mmHg vs. (167. 50 ± 97. 17) mmHg,1 mmHg=0. 133 kPa,P=0. 01] and lower pediatric critical illness score(75. 67 ± 5. 72 vs. 86. 40 ± 8. 88,P=0. 02). There were no differences on sex ratio,kinds of basic diseases,whether with co-infections,the time of immunosuppressant administration, the time from onset to diagnosis,the time from onset to beginning trimethoprim-sulfamethoxazole therapy, PaCO2 ,white blood cell counts,lymphocyte counts,CD4+ cell counts,C-reactive protein,and hemoglobin con-centrations between the survival and non-survival group. Conclusion A higher age, need for mechanical ventilation,lower PaO2/FiO2 and lower pediatric critical illness score were risk factors for mortality in non-HIV infected children with PCP.
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Objective To explore the diagnosis,treatment and nursing of the patients complicated with pneumocystis carinii pneumonia (PCP) after renal transplantation,and to enhance the treatment effect of the disease.Methods The treatment and nursing processes of 37 patients complicated with PCP after renal transplantation in department of organ transplantation were retrospectively analyzed in the First Affiliated Hospital of China Medical University from May 1992 to July 2011.And the key points during nursing work were summarized.Results Of the total 37 patients,10 patients occurred respiratory failure,they were all treated by noninvasive ventilation,among which 6 patients were converted to tracheal intubation or tracheotomy mechanical ventilation.5 patients appeared rising serum creatinine(Scr) during treatment,but recovered to normal level after discontinuing SMZco for 1 week.4 patients died unfortunately,and the others were cured and discharged.Conclusions The occurrence of PCP after renal transplantation is closely related to the immune state of the patients,thus the priority of treatment for PCP should be prevention.Once happened,nursing care in aid is particularly important,then nurses should encourage patients to cooperate with treatment,relieve symptoms after infection,and promote recovery as well.
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Pneumocystis carinii pneumonia (PCP) has rarely been reported in solid tumor patients. It is a well-known complication in immunosuppressed states including acquired immune deficiency syndrome and hematologic malignancy. PCP has been reported in solid tumor patients who received long-term steroid treatment due to brain or spinal cord metastases. We found 3 gastric cancer patients with PCP, who received only dexamethasone as an antiemetic during chemotherapy. The duration and cumulative dose of dexamethasone used in each patient was 384 mg/48 days, 588 mg/69 days, and 360 mg/42 days, respectively. These cases highlight that the PCP in gastric cancer patients can successfully be managed through clinical suspicion and prompt treatment. The cumulative dose and duration of dexamethasone used in these cases can be basic data for risk of PCP development in gastric cancer patients during chemotherapy.
Subject(s)
Humans , Acquired Immunodeficiency Syndrome , Brain , Dexamethasone , Hematologic Neoplasms , Neoplasm Metastasis , Pneumocystis , Pneumocystis carinii , Pneumonia, Pneumocystis , Spinal Cord , Stomach NeoplasmsABSTRACT
Objective To investigate the infection status of HIV/AIDS patients complicated with pneumocystis Carinii Poneumonia(PCP),and the role of CD4+ T lymphocyte in PCP.Methods PC was detected by Giemsa's staining and CD4+ T lymphocyte was counted by flow cytometry.Meanwhile,this text calculated and compared a series of indexes about PC infection,such as the total positive rate,the average annual positive rate,the average monthly positive rate,the positive rate between female and male,the positive rate between sputum and BALF specimens,and the relationship between the positive rate and CD4+ T lymphocyte count.Results The total positive rate about PC infection of the 1 806 eases of sputum specimens was 46.8％,and the incidence mainly from April to July during a year,and the positive rates were 46.3％ and 50.2％ for males and females respectively.The results showed that there were no significant differences when compared with the average annual positive rate ( P ＞ 0.05 ),but there were significant differences when compared with the average monthly positive rate ( P ＜ 0.05 ),the positive rate between female and male(P＞0.05),and among 3 formerly defined ranges of CD4+count(P ＜0.05).Conclusion Giemsa's staining showed the total positive rate was 46.8％ of the HIV/AIDS patients infected by PC with sputum specimens,which represented a seasonal fluctuation tendency.The positive rate of BALF was higher than that in sputum,and it increased with CD4+ count decreasing.Giemsa's staining was an efficient,simple and feasible way for PC detection and easy for generalization.Meanwhile,it is strongly relied on the operator's experience and skill.