Clinical analysis on acquired immune deficiency syndrome combined with pneumocystis carinii pneumonia in 15 cases

Abstract:

Objective：To study and summarize the clinical feature and chest radiograph feature of acquired immune deficiency syn－drome（AIDS）combined with Pneumocystis carinii pneumonia（PCP），so as to improve the clinicians’ understanding of the PCP and the level of diagnosis and treatment. Methods：The clinical data of 15 AIDS patients combined with PCP in respiratory department of our hospital from Mar. 2010 to Sep. 2011 were studied prospectively， including history， signs， chest imageolgy，laboratory tests，lung biopsy pathological examination，treatment，prognosietc，et al. Results：The clinical features of AIDS patients combined with PCP are fever，cough，dyspnea. Patients often have no positive signs in the lungs，some patients could have moist rales（13.3%） or crackles （20%）. The typical chest radiograph feature is ground-glass shadows in both lungs. There is a development tendency from hilar to peripheral lung field，and may be associated with reticular shadows or “gravel sign”. Of 15 patients，only 3 patients were given bron－choalveolar lavage （BALF） and diagnosed with PCP as pneumocystis cysts were found through silver staining of the fluid. The other patients were clinically diagnosed. All the patients were treated with sulfamethoxazole （SMZco，100%） and corticosteroids （86.7%）. Conclusion：Whenever a patient got fever，cough，dyspnea，especially ground glass were found in the lungs by the chest radiograph，AIDS combined with PCP should be highly considered，and diagnostic treatment with SMZco should be performed as soon as possi－ble，so as to reduce misdiagnosis rate and mortality.