Unsuspected Pneumocystis carinii pneumonia and vertically acquired HIV infection in infants requiring intensive care.
When an infant develops acute respiratory failure of sufficient severity to necessitate supportive mechanical ventilation a cause should always be sought. A chest radiograph showing predominantly interstitial lung disease and an infant's failure to respond to standard antibiotic treatment are indications for non-bronchoscopic bronchoalveolar lavage. If P carinii pneumonia is diagnosed a congenital immunodeficiency should be sought and the parents counselled about HIV infection. Earlier investigation may be indicated by features of immunodeficiency when taking a history, performing a general examination, or analysing the results of basic haematological testing.
Tasker
R C
RC
Paediatric Intensive Care Unit, Hospital for Sick Children, London.
Wilkinson
K
K
Slater
T J
TJ
Novelli
V
V
D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000635:transmission; D006801:Humans; D007223:Infant; D015931:Intensive Care, Neonatal; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000628:therapy