Management of Pneumocystis carinii pneumonia in patients with conventionally caused immune suppression.

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Ten non-AIDS patients with <I>Pneumocystis carinii</I> pneumonia were studied. While the 2 patients with adult T cell leukemia had longer prodromes, the other 8 patients had acute onset. At presentation a chest radiograph revealed an abnormal bilateral diffuse shadow in all cases. In 8 patients, diagnostic material was obtained by transbronchial lung biopsy and/or bronchoalveolar lavage, and in 2 patients at postmortem. At the time of diagnosis the serum lactate dehydrogenase value was much higher than prior to the acute illness, and the AaDO<SUB>2</SUB> gradient was highly increased : These appear to be useful as markers for an initial diagnosis. Other opportunistic organisms were isolated in 5 patients. The concomitant use of pentamidine and cotrimoxazole was relatively well tolerated, but with a high incidence of treatment failure. Corticosteroids appeared to be effective as an adjunctive therapy.
日本熱帯医学会の論文