Percutaneos pulmonary needle diagnosis of Pneumocystis carinii pneumonitis.

Percutaneous pulmonary needle aspiration (PC-A) is one of several diagnostic techniques capable of providing material in which Pneumocystis carinii organisms can be identified. This simple procedure, readily performed by most physicians, can be rapidly done under local anesthesia, requiring no sedation, general anesthetic, or multiple support personnel. When the chest roentgenographic evidence suggests diffuse involvement, PC-A may be performed at the bedside; if more patchy in distribution, under fluoroscopic guidance. Diagnostic yield approximates 80% or more on on the first attempt and approaches 100% if repeat PC-A is done after an initially negative PC-A procedure. Underlying severe bleeding disorders may lead to serious hemorrhage. Pneumothorax is not uncommon but is usually of no clinical significance and, if necessary,, is readily controlled. Percutaneous pulmonary needle biopsy with cutting or coring needles is not recommended because of a higher complication rate.