title: Relationship between Radiological Stages and Prognoses of Pneumocystis Pneumonia in Non-AIDS Immunocompromised Patients.
abstract: BACKGROUND
  Although radiological features of pneumocystis pneumonia (PCP) in non-Acquired Immune Deficiency Syndrome (AIDS) immunocompromised patients have been reported by other authors, there were no studies on the radiological stages of PCP previously. This study aimed to elucidate the radiological stages and prognoses of PCP in non-AIDS immunocompromised patients.
  
  
  METHODS
  Retrospective analysis of radiological manifestations and prognoses of 105 non-AIDS PCP immunocompromised patients from August 2009 to April 2016 was conducted. Chest radiograph was divided into three stages: early stage (normal or nearly normal chest radiograph), mid stage (bilateral pulmonary infiltrates), and late stage (bilateral pulmonary consolidations); chest high-resolution computed tomography (HRCT) was also divided into three stages: early stage (bilateral diffuse ground-glass opacity [GGO]), mid stage (bilateral diffuse GGO and patchy consolidations), and late stage (bilateral diffuse consolidations).
  
  
  RESULTS
  The case fatality rate (CFR) of all patients was 34.3% (36/105), all of them took routine chest X-ray (CXR), and 84 underwent chest CT examinations. According to the CXR most near the beginning of anti-PCP therapy, 18 cases were at early stage and CFR was 0 (0/18, P< 0.01), 50 cases were at mid stage and CFR was 28.0% (14/50, P> 0.05), and 37 cases were at late stage and CFR was 59.5% (22/37, P< 0.01). According to the chest HRCT most near the beginning of anti-PCP therapy, 40 cases were at early stage and CFR was 20.0% (8/40, P> 0.05), 34 cases were at mid stage and CFR was 47.1% (16/34, P> 0.05), and 10 cases were at late stage and CFR was 80.0% (8/10, P< 0.05); barotrauma, including pneumothorax, pneumomediastinum, and pneumohypoderma, was found in 18 cases and the CFR was 77.8% (14/18, P< 0.01).
  
  
  CONCLUSIONS
  Based on the radiological manifestations, the course of PCP in non-AIDS immunocompromised patients can be divided into three stages: early stage, mid stage, and late stage. The prognoses of patients treated at early stage are good, and those at late stage are poor. Furthermore, the CFR of patients with barotrauma is high.
authors: Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
authors: Xiang-Dong
authors: XD
authors: Mu
authors: Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
authors: Peng
authors: P
authors: Jia
authors: Department of Radiology, Peking University First Hospital, Beijing 100034, China.
authors: Li
authors: L
authors: Gao
authors: Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
authors: Li
authors: L
authors: Su
authors: Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
authors: Cheng
authors: C
authors: Zhang
authors: Department of Radiology, Beijing Shijitan Hospital, Beijing 100038, China.
authors: Ren-Gui
authors: RG
authors: Wang
authors: Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
authors: Guang-Fa
authors: GF
authors: Wang
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000401:mortality / Q000473:pathology; D000328:Adult; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed