ABSTRACT
To delineate clinical and histological features of the first Pneumocystis carinii infection affecting the immunocompetent host, P. carinii-specific histological stains were performed on autopsy lung specimens from 534 consecutive pediatric patients (those with AIDS and malignancies were excluded) in Santiago, Chile. P. carinii clusters were found in 4 (25%) of 16 infants who died of no apparent cause at arrival to the emergency department, and in 10 (2.9%) of 342 infants who died of multiple conditions at the hospital (P=.002, Fisher's exact test). This prompted us to analyze additional series of infants with sudden infant death syndrome (SIDS). In 161 additional SIDS cases, 47 (35.1%) of 134 infants from Chile and 4 (14.8%) of 27 infants from Oxford, United Kingdom, were found to have P. carinii clusters in the lungs. The quantity of P. carinii cysts was small compared with the numbers seen in immunocompromised hosts with P. carinii pneumonitis. This study provides histological evidence that primary P. carinii infection is associated with SIDS.
Subject(s)
Pneumocystis Infections/epidemiology , Sudden Infant Death/epidemiology , Autopsy , Chile/epidemiology , Histocytochemistry , Humans , Infant , Infant, Newborn , Lung/microbiology , Lung/pathology , Pneumocystis , Pneumocystis Infections/microbiology , Retrospective Studies , Severity of Illness Index , Sudden Infant Death/pathologyABSTRACT
Intestinal tuberculosis is rare compared to other forms of the disease. A review of the last 10 years in a General University hospital identified 21 cases diagnosed at autopsy and 8 during life. Most patients were males, older than 30 years of age, alcoholics and originating in southern Chile. Evidence of concomitant pulmonary tuberculosis was frequent. Disease was located most commonly at the ileum and cecum, and surgery was needed in a high proportion of cases. Hepatic cirrhosis and lymphopenia were common findings in autopsy patients.
