title: Aerosolized pentamidine: effect on diagnosis and presentation of Pneumocystis carinii pneumonia.
abstract: OBJECTIVE
  To determine the effect of previous aerosolized pentamidine therapy on diagnosis and presentation of Pneumocystis carinii pneumonia.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  A tertiary care hospital.
  
  
  METHODS
  Fifty-two consecutive patients with P. carinii pneumonia and underlying infection with the human immunodeficiency virus (HIV) who had bronchoscopy. Twenty-one patients who were on aerosolized pentamidine therapy served as the study group. Thirty-one patients who had not received the drug served as the control group.
  
  
  RESULTS
  The yield of bronchoalveolar lavage for P. carinii pneumonia was 62% for the study group and 100% for the control group (P less than 0.05). This lower yield was significant for the subset of patients having their first episode of P. carinii pneumonia. The yield of transbronchial biopsy was similar for both groups of patients (81% compared with 84%). The yield of bronchoscopy was not influenced by use of zidovudine. Review of lavage specimen slides suggested that there may be fewer organisms present in patients receiving aerosolized pentamidine. An atypical roentgenographic presentation of upper lobe predominant infiltrates was seen in 38% of the study patients and 7% of the control patients. In addition, pneumothoraces and cystic changes were also frequently seen in the study patients. Gallium scans, when done, were also atypical in the study group. Markers of the severity of disease, however, were similar in both groups.
  
  
  CONCLUSIONS
  The yield of bronchoalveolar lavage for P. carinii pneumonia in HIV-infected patients is lower in patients receiving aerosolized pentamidine. Unusual roentgenographic presentations and atypical gallium scans are also found in this setting.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: K M
authors.initials: KM
authors.lastname: Jules-Elysee
authors.forename: D E
authors.initials: DE
authors.lastname: Stover
authors.forename: M B
authors.initials: MB
authors.lastname: Zaman
authors.forename: E M
authors.initials: EM
authors.lastname: Bernard
authors.forename: D A
authors.initials: DA
authors.lastname: White
mesh_terms: D000336:Aerosols; D001706:Biopsy; D001980:Bronchi / Q000473:pathology; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D001999:Bronchoscopy; D005710:Gallium Radioisotopes; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D010419:Pentamidine / Q000008:administration & dosage / Q000494:pharmacology*; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis* / Q000517:prevention & control; D011859:Radiography; D012008:Recurrence; D012720:Severity of Illness Index; D015215:Zidovudine / Q000494:pharmacology
chemical_list: D000336:Aerosols; D005710:Gallium Radioisotopes; D015215:Zidovudine; D010419:Pentamidine