Aerosolized pentamidine: Effect on diagnosis and presentation of Pneumocystis carinii pneumonia Journal Article


Authors: Jules-Elysee, K. M.; Stover, D. E.; Zaman, M. B.; Bernard, E. M.; White, D. A.
Article Title: Aerosolized pentamidine: Effect on diagnosis and presentation of Pneumocystis carinii pneumonia
Abstract: Study Objective: To determine the effect of previous aerosolized pentamidine therapy on diagnosis and presentation of Pneumocystis carinii pneumonia. Design: A retrospective study. Setting: A tertiary care hospital. Patients: Fifty-two consecutive patients with P. carinii pneumonia and underlying infection with the human immunodeficiency virus (HIV) who had bronchoscopy. Twenty-one patients who were on aerosolized pentamidine therapy served as the study group. Thirty-one patients who had not received the drug served as the control group. Measurements and Main Results: The yield of bronchoalveolar lavage for P. carinii pneumonia was 62% for the study group and 100% for the control group (P < 0.05). This lower yield was significant for the subset of patients having their first episode of P. carinii pneumonia. The yield of transbronchial biopsy was similar for both groups of patients (81% compared with 84%). The yield of bronchoscopy was not influenced by use of zidovudine. Review of lavage specimen slides suggested that there may be fewer organisms present in patients receiving aerosolized pentamidine. An atypical roentgenographic presentation of upper lobe predominant infiltrates was seen in 38% of the study patients and 7% of the control patients. In addition, pneumothoraces and cystic changes were also frequently seen in the study patients. Gallium scans, when done, were also atypical in the study group. Markers of the severity of disease, however, were similar in both groups. Conclusion: The yield of bronchoalveolar lavage for P. carinii pneumonia in HIV-infected patients is lower in patients receiving aerosolized pentamidine. Unusual roentgenographic presentations and atypical gallium scans are also found in this setting.
Keywords: controlled study; major clinical study; recurrence; pneumocystis pneumonia; biopsy; severity of illness index; lung; bronchoscopy; acquired immune deficiency syndrome; lung biopsy; bronchi; pentamidine; hiv infections; zidovudine; lung lavage; bronchoalveolar lavage fluid; aerosol; aerosols; gallium radioisotopes; human; priority journal; article; inhalational drug administration; pneumonia, pneumocystis carinii
Journal Title: Annals of Internal Medicine
Volume: 112
Issue: 10
ISSN: 0003-4819
Publisher: American College of Physicians  
Date Published: 1990-05-15
Start Page: 750
End Page: 757
Language: English
DOI: 10.7326/0003-4819-112-10-750
PUBMED: 2331119
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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MSK Authors
  1. Dorothy A White
    72 White
  2. Edward M Bernard
    48 Bernard
  3. Muhammad B Zaman
    17 Zaman