Pneumocystis carinii pneumonia is caused by Pneumocystis carinii. It usually occurs in premature or debilitated infants. Recently sporadic cases of human disease in patients who have been on long term steroid therapy, cytotoxic drug therapy, immunosuppressive drug were significantly increased. We recently experienced 35 cases of Pneumocystis carinii pneumonia in infants of an institution for foreign adoption in three epidemic period of Feb.1979, Mar. 1980, and Jan. 1980. The clinical review of 35 cases was made. Patients' age was between 1 to 4 months. Twenty-one cases (60%) occurred in 2-month-old infants. Many patients were included in poor weight gain and development. The common symptoms were tachypnea, cyanosis, restlessness, cough, diarrhea in order of frequency. The roentgenological findings were classified into three groups. normal finding, pulmonary emphysema only, and various forms of pneumonic infiltration. The roentgenological findings were somewhat characteristic. The most common finding (24 cases) showed streaky and mottled densities which began in both hill and were spreaded peripherally. The pneumonic infiltrations were spared peripheral lung, but progressed to total involvement. The prominence between alveolar and interstitial infiltration was almostly equal when patients were admitted. Nineteen cases (54%) showed pulmonary emphysema.
Cough ; Cyanosis ; Diarrhea ; Drug Therapy ; Humans ; Infant ; Lung ; Pneumocystis carinii ; Pneumonia ; Pneumonia, Pneumocystis ; Psychomotor Agitation ; Pulmonary Emphysema ; Tachypnea ; Weight Gain

We experienced a 61-year old man with Pneumocystis carinii pneumonia who had been diagnosed as having relapsed acute myelogenous leukemia(AML). He developed severe dyspnea in the nadir state after reinduction chemotherapy. His chest X-ray showed bilateral interstitial pneumonia in both lung fields. We started ventilator therapy and obtained sputum through the endotracheal tube. Typical P. carinii cysts were found in the sputum by Giemsa stain. No other organisms were found in thelavage sediments. From clinical observation and the presence of typical P. carinii cysts, the patient was diagnosed as having P. carinii pneumonia and was treated with sulfamethoxazole/trimethoprim and glucocorticoid. This was the first reported case of P. carinii pneumonia in an AML patient undergoing chemotherapy in Korea.
Azure Stains ; Drug Therapy ; Dyspnea ; Humans ; Korea ; Leukemia ; Leukemia, Myeloid, Acute* ; Lung ; Lung Diseases, Interstitial ; Middle Aged ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Sputum ; Thorax ; Ventilators, Mechanical

Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Male ; Middle Aged ; Pneumocystis carinii ; Pneumonia, Pneumocystis ; drug therapy ; etiology ; mortality ; Risk Factors

Acute respiratory failure with diffuse pulmonary infiltration was occurred in a patient with malignant lymphoma 1month after the 8th CHOP chemotherapy. The ground glass and consolidation appearances on chest C-T in this immunodeficient patient could be presented in many clinical situations such as pneumonia by opportunistic infections(fungal, parasites, viral, and usual bacterial pathogens), anti-tumor drug's pulmonary toxicity and tumor invasion. And the other diseases of acute interstitial pneumonitis, alveolar proteinosis, BOOP, pulmonary edema and alveolar hemorrhage, which could present the same radiological findings, should included in differential diagnosis. This patient was diagnosed as the opportunistic pneumonia by Pneumocystis carinii and probably Cytomegalovirus through bronchoalveolar lavage and transbronchial lung biopsy.
Biopsy ; Bronchoalveolar Lavage ; Cryptogenic Organizing Pneumonia ; Cytomegalovirus ; Diagnosis, Differential ; Drug Therapy* ; Glass ; Hemorrhage ; Humans ; Lung ; Lung Diseases, Interstitial ; Lymphoma* ; Parasites ; Pneumocystis carinii ; Pneumonia ; Pulmonary Edema ; Respiratory Insufficiency ; Thorax

Pneumonia is a fatal disease in immunocompromised patients including bone marrow transplantation recipients. Etiological agents include fungi, cytomegalovirus, Pneumocystis carinii, influenza virus and parainfluenza virus. We describe a community-acquired respiratory syncytial virus pneumonia in a patient who received intense chemotherapy followed by peripheral stem cell transplantation for acute leukemia. The patient was treated with intravenous immunoglobulin and ribavirin aerosol. About 1 month later, she was recovered.
Bone Marrow Transplantation ; Cytomegalovirus ; Drug Therapy ; Fungi ; Humans ; Immunocompromised Host ; Immunoglobulins ; Leukemia ; Orthomyxoviridae ; Paramyxoviridae Infections ; Peripheral Blood Stem Cell Transplantation* ; Pneumocystis carinii ; Pneumonia* ; Respiratory Syncytial Viruses* ; Ribavirin

This study was performed to observe the therapeutic effects of interferon-gamma(IFN-gamma) and gamma-globulin(gamma-globulin) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxazole(TMP-SMZ; 10-50 mg/mouse/day), mouse IFN-gamma(5 x 10(4) units/mouse/day) and mouse gamma-globulin(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopathologic and electron microscopic findings of the lungs, and number of P. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with IFN-gamma or gamma-globulin, and in the group of TMP-SMZ treatment (p < 0.05), however, little effect was found in the group of gamma-globulin alone. Histopathologic findings of P. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with IFN-gamma. Treatment with either TMP-SMZ or IFN-gamma significantly reduced the number of cysts in the P. carinii pneumonia, but gamma-globulin alone was ineffective. In electron microscopic findings of P. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or IFN-gamma, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with IFN-gamma had synergistic effects in treatment of P. carinii pneumonia in experimental mice.
Drug-Synergism ; Drug-Therapy,-Combination ; English-Abstract ; Gamma-Globulins-administration-and-dosage ; Interferon-Type-II-administration-and-dosage ; Mice- ; Trimethoprim-Sulfamethoxazole-Combination-administration-and-dosage ; *Gamma-Globulins-therapeutic-use ; *Interferon-Type-II-therapeutic-use ; *Pneumonia,-Pneumocystis-carinii-therapy ; Gamma-Globulins ; Trimethoprim-Sulfamethoxazole-Combination ; Interferon-Type-II