title: [Dramatic improvement of severe Pneumocystis carinii pneumonia by corticosteroids despite lack of antipneumocystis therapy in acquired immunodeficiency syndrome].
abstract: A 30-year-old Thai man was admitted to our hospital complaining of general fatigue, pyrexia, dyspnea, and a productive cough. He was in serious respiratory failure and had a PaO2 of 45.9 Torr in room air. Chest radiography showed marked infiltration of both lungs. Pneumocystis carinii pneumonia (PCP) associated with acquired immunodeficiency syndrome (AIDS) was ruled out by a negative test for HIV antibody. He was given corticosteroids including methylprednisolone mini-pulse therapy and antibiotics. This therapy improved his condition and his radiological picture dramatically without antipneumocystis therapy. Bronchoscopy was performed and the transbronchial lung biopsy revealed PCP. On re-examination for HIV-1 antibody, the result was positive. Western blot analysis yielded a definite diagnosis of HIV-1 infection. Our experience strongly supports previous reports that advocated corticosteroids as adjunctive therapy for moderate to severe PCP associated with AIDS and gives us the significance of corticosteroids.
authors.affiliation: Department of Internal Medicine, Fuji City General Hospital, 50 Takashima-cho, Fuji, Shizuoka 417-8567, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Uchida
authors.forename: Y
authors.initials: Y
authors.lastname: Inoue
authors.forename: A
authors.initials: A
authors.lastname: Kojima
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy*; D000328:Adult; D015497:HIV-1; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis / Q000188:drug therapy*; D011239:Prednisolone / Q000008:administration & dosage; D020551:Pulse Therapy, Drug; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D011239:Prednisolone; D008775:Methylprednisolone