Delcourt J N, Besson-Léaud M, Prat J J, Lavaud J, Nézelof C
Arch Fr Pediatr. 1979 Nov;36(9):873-84.
The availability of drugs that are active against Pneumocystis carinii has renewed interest in and underlined the difficulties of the early diagnosis pneumocystis pneumonia. A retrospective study of 33 cases was undertaken to define the optimal management. It is necessary to take into consideration the high mortality of the untreated condition and the risks of investigation and of treatment. Pneumocystis pneumonia affects only those patients who are immunologicaly incompetent, particularly those with defects of cellular immunity. Early symptoms are common but they are insidious. Indirect immunofluorescent tests were positive in 75% of our cases and were useful as screening tests. However it is necessary to identify the parasite (in our cases it was detected in 29 patients) and this requires invasive techniques such as lung puncture, lung biopsy or bronchial brushing. The best method for the rapid diagnosis of pneumocystis is endobronchial brushing, because it is simple, effect and has few complications.
有了对卡氏肺孢子虫有效的药物，重新引发了人们对肺孢子虫肺炎早期诊断的关注，并凸显了其困难之处。我们进行了一项对33例病例的回顾性研究，以确定最佳治疗方案。必须考虑到未经治疗情况下的高死亡率以及检查和治疗的风险。肺孢子虫肺炎仅影响那些免疫功能不全的患者，尤其是那些细胞免疫有缺陷的患者。早期症状很常见，但很隐匿。间接免疫荧光试验在我们75%的病例中呈阳性，可作为筛查试验。然而，有必要识别该寄生虫（在我们的病例中，29例患者检测到该寄生虫），这需要采用侵入性技术，如肺穿刺、肺活检或支气管刷检。快速诊断肺孢子虫的最佳方法是支气管内刷检，因为它简单、有效且并发症少。
