Fortún J, Hermida J M, Hernández-Cabrero J, Martí-Belda P, Sueiro A, Fogué L, Sanz I, Buzón L
Unidad de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid.
Enferm Infecc Microbiol Clin. 1990 Feb;8(2):82-7.
Thirty cases of a first episode of Pneumocystis carinii pneumonia in patients with HIV infection were collected in a 32 month period. Most patients had long standing fever, cough and dyspnea. Laboratory findings were nonspecific. Remarkably, LDH activity was high in 88% of patients and the T4 lymphocyte count was lower than 200/mm3 in all patients in whom it was measured. Chest radiogram showed bilateral alveolar-interstitial pattern in 90% of cases. Bronchoalveolar lavage with ultracentrifugation was found to be the most effective diagnostic study, with 95% sensitivity. The frequency of secondary effects to cotrimoxazole which required to change to pentamidine was 13.3%. During hospital admission, 16.6% of the patients died, and the survivors had mortality rates of 4% and 85% after 3 and 20 months, respectively.
在32个月的时间里收集了30例首次发生卡氏肺孢子虫肺炎的HIV感染患者。大多数患者长期发热、咳嗽和呼吸困难。实验室检查结果无特异性。值得注意的是，88%的患者乳酸脱氢酶活性升高，所有检测过的患者T4淋巴细胞计数均低于200/mm³。胸部X线片显示90%的病例有双侧肺泡-间质型。经超速离心的支气管肺泡灌洗被发现是最有效的诊断方法，敏感性为95%。因复方新诺明的副作用而需要改用喷他脒的发生率为13.3%。住院期间，16.6%的患者死亡，存活者在3个月和20个月后的死亡率分别为4%和85%。
