[Clinicopathological study of 10 cases of Pneumocystis carinii pneumonia].

A retrospective study was conducted to evaluate the prognostic factors in patients with Pneumocystis carinii pneumonia (PCP). From 1976 through 1991, a total of 10 PCP cases were pathologically diagnosed of our hospital. All patients were immunocompromised hosts treated with corticosteroids and/or cytotoxic drugs for their underlying diseases of malignancy in 6 and autoimmune disease in 4. The frequent symptoms in the early stage of PCP were fever in 9 and dry cough in 4 patients. The chest X-ray exhibited bilateral diffuse infiltrates in all patients. In 3 patients, the infiltrates which were localized at the early stage progressed rapidly to both lungs in a few days. All of the 3 patients in 1970-79 were diagnosed by autopsy without effective treatment. Four of the 5 patients in 1980-89 were diagnosed by autopsy or necropsy and one patient was diagnosed by transbronchial lung biopsy (TBLB). All the 5 patients in 1980-89, including 3 patients treated with sulfamethoxazole and trimethoprim (ST), died. Two patients in 1990-93 who were diagnosed by examination of TBLB or sputum specimen recovered from PCP following treatment with ST. These results indicate that the early diagnosis of PCP by the development of diagnostic techniques followed by effective treatment with anti-PCP drugs has greatly improved the outcome of PCP.