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Correlation of the semi-quantitative evaluation of Pneumocystis carinii in bronchoalveolar lavage fluid with the course and outcome of Pneumocystis carinii pneumonia in AIDS patients.
Anwar D; Jolidon RM; Bille J; Leuenberger P; Schnyder P; Chave JP;
November 30, 1993
Int Conf AIDS. 1993 Jun 6-11;9(1):434 (abstract no. PO-B17-1796). Unique

OBJECTIVE: To test the correlation between the semi-quantitative analysis of cysts (C) and sporozoites (S) of Pneumocystis carinii PC) in broncho-alveolar lavage fluid (BALF) and the severity and outcome of PC pneumonia (PCP). METHODS: Demographic, clinical, and microbiological data were collected for all HIV-infected patients with PCP diagnosed in CHUV by BAL from Jan 1990 to Dec 1991. Microbiological evaluation comprised the presence of C Silver-Stain and Gram-Weigert) and S (Giemsa) and their quantity 1+ to 4+). Two groups were formed: A < or = 2+, B > 2+. Usual prognostic indices (UPI) of severity of PCP (LDH, AaDO2, neutrophil counts in BALF) were also compared with clinical course. RESULTS: 47 BALF from 43 patients were reviewed. The correlation between the number of C and S was good. Groups A and B had similar severity of infection based on our microbiological scoring system and clinical data. UPI were associated with increased severity of illness (corticosteroid use, hospitalization, X-ray data), with p < 0.05 for all indices. CONCLUSIONS: Neither the number of C nor S in BALF correlated with severity of PCP, whereas the value of UPI was confirmed. We postulate that the presence of PC may initiate pathologic changes, independently of their number. Therefore, optimal therapy must be based only on clinical course and UPI.

*AIDS-Related Opportunistic Infections/MICROBIOLOGY *Bronchoalveolar Lavage Fluid/MICROBIOLOGY *Pneumocystis carinii/ISOLATION & PURIF