Pneumocystis pneumonia: clinical presentation and diagnosis in patients with and without acquired immune deficiency syndrome.
Pneumocystis pneumonia: clinical presentation and diagnosis in patients with and without acquired immune deficiency syndrome.
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发表时间：
1998-12
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通讯作者：
Thomas Cf;Limper Ah
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作者：
Thomas Cf;Limper Ah
卡氏肺囊虫在免疫功能低下的宿主中引起严重的肺炎。虽然这种情况最常见于获得性免疫缺陷综合征（艾滋病）患者，但其他无艾滋病的免疫功能低下患者也有卡氏杆菌肺炎的风险。这些患者患有实体或血液系统恶性肿瘤、器官移植或需要慢性免疫抑制药物（特别是皮质类固醇）的炎症。有和没有艾滋病患者卡氏假体肺炎的临床表现有重要的差异。卡氏杆菌在非艾滋病患者中引起急性暴发性肺炎，而艾滋病患者则有更隐蔽的参与。这些组之间的机体负荷和肺部炎症反应明显不同，导致临床表现、结果和死亡率存在实质性差异。卡氏杆菌肺炎的诊断对初级保健医生和专家来说仍然具有挑战性。卡氏假体肺炎的具体诊断需要证明该有机体来自临床相关来源，如痰、支气管肺泡灌洗液或肺组织。诊断卡氏杆菌肺炎的替代方法目前正在研究中，是一个活跃的研究领域。卡氏假体肺炎的快速和特异性诊断允许制定特异性治疗和改善患者预后。
Pneumocystis carinii causes severe pneumonia in immunocompromised hosts. Although this most commonly occurs in patients with the acquired immunodeficiency syndrome (AIDS), other groups of immunocompromised patients without AIDS are also at risk for P. carinii pneumonia. These patients have solid or hematologic malignancies, organ transplantation, or inflammatory conditions requiring chronic immunosuppressive drugs, particularly corticosteroids. There are important differences in the clinical presentation of P. carinii pneumonia in patients with and without AIDS. P. carinii causes an acute fulminate pneumonia in patients without AIDS while patients with AIDS have more insidious involvement. The organism burden and lung inflammatory response are markedly different between these groups, contributing to substantial differences in clinical presentation, outcome, and mortality. The diagnosis of P. carinii pneumonia remains challenging for primary care physicians and specialists alike. The specific diagnosis of P. carinii pneumonia requires demonstration of the organism from a clinically relevant source, such as sputum, bronchoalveolar lavage fluid, or lung tissue. Alternative methods to diagnose P. carinii pneumonia are currently investigational and are an active area of research. The rapid and specific diagnosis of P. carinii pneumonia allows institution of specific treatment and improvement in patient outcome.