Current course of pneumocystic pneumonia in HIV-infected patients
- Authors: Ermak T.N.1, Samitova E.R.2, Tokmalaev A.K.2, Kravchenko A.V.1, Ermak TN3, Samitova ER4, Tokmalaev AK4, Kravchenko AV3
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Affiliations:
- ФБУН ЦНИИ эпидемиологии Роспотребнадзора
- ГОУ Российский университет дружбы народов
- Central Research Institute of Epidemiology, Moscow
- Russian University of Peoples' Friendship, Moscow
- Issue: Vol 83, No 11 (2011)
- Pages: 19-24
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/30918
- ID: 30918
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Abstract
Material and methods. Detailed examination was performed in 111 HIV-infected patients with suggested diagnosis of PP. The following investigations were made: clinical, x-ray examinations, total count and biochemical blood tests, enzyme immunoassay, indirect immunofluorescence reaction (IIFR) for Pneumocystis jiroveci antigens in bronchoalveolar lavage fluid (BALF)or induced sputum. For diagnosis of other secondary diseases PCR was used for investigation of BALF and bronchial biopsy to detect DNA of Mycobacterium tuberculosis complex, Candida albicans, Cytomegalovirus, Toxoplasma gondii, Mycoplasma spа., Herpes simplex I, II. DNA of cytomegalovirus in blood was detected with PCR. Microscopic tests of the sputum were conducted for detection of acid-resistant mycobacteria.
Results. PP was associated with other secondary diseases in 59% patients (pulmonary tuberculosis - 16%, CMV pneumonia - 31%, combination of all the lesions - 5%).PP diagnosis was cancelled and pulmonary tuberculosis was diagnosed in 12 patients.In combination of PP with other pathology dominant were symptoms observed in PP monoinfection and only effective anti-pneumocystic treatment revealed signs of comorbid pathology. Tuberculosis patients had weaker signs of respiratory failure, symmetric bilateral interstitial or small-focal alterations were detected less frequently.
Conclusion. Current PP course characteristics in HIV infection are identified. In clinical diagnosis of PP special attention should be paid to data complex especially to increasing respiratory failure, high ESR, elevated lactate dehydrogenase, low blood pO2, fast response to ex juvantibus therapy. The most effective method of the diagnosis verification - BALF IIFR.
About the authors
Tat'yana Nikiforovna Ermak
ФБУН ЦНИИ эпидемиологии Роспотребнадзора
Email: ermak@hivrussia.net
вед. науч. сотр. СНИО ЭПСПИД ФБУН ЦНИИ эпидемиологии Роспотребнадзора, тел.: 8-495-366-05-18; ФБУН ЦНИИ эпидемиологии Роспотребнадзора
El'vira Rastyamovna Samitova
ГОУ Российский университет дружбы народоваспирант каф. инфекционных болезней с курсом эпидемиологии ГОУ РУДН, тел.: 8-495-365-25-33, 8-495-365-32-41; ГОУ Российский университет дружбы народов
Anatoliy Karpovich Tokmalaev
ГОУ Российский университет дружбы народовпроф. каф. инфекционных болезней с курсом эпидемиологии ГОУ РУДН; ГОУ Российский университет дружбы народов
Aleksey Viktorovich Kravchenko
ФБУН ЦНИИ эпидемиологии Роспотребнадзоравед. науч. сотр. СНИО ЭПСПИД ФБУН ЦНИИ эпидемиологии Роспотребнадзора; ФБУН ЦНИИ эпидемиологии Роспотребнадзора
T N Ermak
Central Research Institute of Epidemiology, MoscowCentral Research Institute of Epidemiology, Moscow
E R Samitova
Russian University of Peoples' Friendship, MoscowRussian University of Peoples' Friendship, Moscow
A K Tokmalaev
Russian University of Peoples' Friendship, MoscowRussian University of Peoples' Friendship, Moscow
A V Kravchenko
Central Research Institute of Epidemiology, MoscowCentral Research Institute of Epidemiology, Moscow
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