An Esp Pediatr. 1996 Dec;45(6):570-4. Unique Identifier : AIDSLINE
OBJECTIVE: The objective of this study was to ascertain the clinical and
epidemiological characteristics of Pneumocystis carinii pneumonia (PCP)
cases admitted to the Pediatric Intensive Care Unit (PICU). PATIENTS AND
METHODS: A retrospective study was carried out on the 8 PCP cases
admitted to the PICU from July 1991 to September 1994. The variables
studied were: age, sex, geographic origin, associated pathology,
immunological status, clinical manifestations, biochemical data,
radiology, findings in bronchoalveolar lavage fluid (BAL), response to
therapy and clinical follow-up. RESULTS: Age of the patients varied
between 3 months and 9 years and there were 5 males and 3 females.
Associated pathologies included AIDS (4 cases), severe combined
immunodeficiency (SCID), Job's syndrome, and immunodeficiencies
secondary to non-Hodgkin's lymphoma (NHL) and acute lymphoid leukemia
(ALL), one case of each. Four cases appeared in a 22 day period. All
cases but one suffered acute respiratory failure and needed mechanical
ventilation. Diagnosis was established by means of BAL in every case.
All cases showed a bilateral diffuse alveolo-interstitial pattern on
chest films. Treatment was trimethoprim-sulfamethoxazole. In the acute
illnesses, 2 patients died (cases of terminal SCID and NHL).
CONCLUSIONS: To date, epidemic presentation of PCP has not been reported
in our community. Four of our cases, with no demonstrable previous
relation, appeared over a short period of time. We have not found a
relationship between LDH levels and severity, as expressed by mechanical
ventilation time. Every AIDS case survived the acute episode and CD4
counts were normal in most cases.
*Pneumonia, Pneumocystis carinii/COMPLICATIONS *Respiratory