Analysis of induced sputum for the diagnosis of recurrent Pneumocystis carinii pneumonia.
We studied the sensitivity of ISA for diagnosis of second-episode PCP in AIDS patients. We induced sputum in 218 patients who had known or suspected AIDS and who had a presentation suggestive of PCP. All patients with negative sputum smear for PCP underwent BAL. Twenty-five patients were identified who had second-episode PCP at least 30 days after initial diagnosis. Chest roentgenographic infiltrate patterns for these 25 patients were blindly scored as normal, diffuse, upper lobe or focal non-upper lobe. The sensitivity of ISA was 72 percent for the first episode of PCP, 72 percent for the second episode of PCP, 72 percent for patients with second-episode PCP who had initial PCP detected by ISA and 71 percent for patients with second-episode PCP whose first episode of PCP was missed by ISA. Of the ten patients who were treated with AP, only one had a false-negative sputum analysis. A comparison of patients who had second-episode PCP diagnosed by ISA with those who had false-negative sputum analysis showed no difference in time to relapse, chest x-ray film pattern (all diffuse) or use of AP.
Kirsch
C M
CM
Department of Medicine, Santa Clara Valley Medical Center, San Jose, Calif. 95128.
Jensen
W A
WA
Kagawa
F T
FT
Azzi
R L
RL
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000175:diagnosis*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D001992:Bronchoalveolar Lavage Fluid / Q000473:pathology; D005188:False Negative Reactions; D006801:Humans; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000175:diagnosis*; D012008:Recurrence; D013183:Sputum / Q000166:cytology*