Lau W K, Young L S, Remington J S
JAMA. 1976 Nov 22;236(21):2399-402. doi: 10.1001/jama.236.21.2399.
To determine if examination of respiratory secretions is useful in diagnosing Pneumocystis carinii pneumonia, smear preparations of expectorated sputum, tracheal aspirates, and transtracheal aspirates stained by the Gomori methenamine silver nitrate method were examined. Pneumocysts were observed more frequently in material obtained by transtracheal aspiration than in secretions obtained by the other methods. Transtracheal aspiration yielded material containing pneumocysts in 8 (13%) of 60 patients; each had pulmonary infiltrates and clinical courses consistent with P carinii pneumonia. Of 330 smear preparations examined from expectorated sputum, three patients had pneumocysts in their sputum and one had organisms in both transtracheal aspiration and expectorated sputum; all three had pneumonia. This study provides evidence that transtracheal aspiration is a useful initial step in the approach to the diagnosis of P carinii pneumonia.
为确定检查呼吸道分泌物对诊断卡氏肺孢子虫肺炎是否有用，我们对用Gomori硝酸银甲胺法染色的咳出痰液、气管吸出物和经气管吸出物的涂片进行了检查。经气管吸出物中观察到肺孢子囊的频率高于其他方法获取的分泌物。在60例患者中，有8例（13%）经气管吸出物中含有肺孢子囊；每例均有肺部浸润及与卡氏肺孢子虫肺炎相符的临床病程。在从咳出痰液检查的330份涂片标本中，3例患者痰液中有肺孢子囊，1例在经气管吸出物和咳出痰液中均有病原体；这3例均患有肺炎。本研究提供的证据表明，经气管吸出术是诊断卡氏肺孢子虫肺炎方法中的一个有用的起始步骤。
