Empirically treated Pneumocystis carinii pneumonia in Los Angeles, Chicago, and Miami: 1987-1990.
Empirically treated Pneumocystis carinii pneumonia in Los Angeles, Chicago, and Miami: 1987-1990.
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洛杉矶、芝加哥和迈阿密经验性治疗卡氏肺孢子虫肺炎：1987-1990 年。
DOI：
10.1093/infdis/172.1.312
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Simberkoff,MS
中科院分区：
文献类型：
--
作者：
Bennett,CL;Horner,RD;Weinstein,RA;Kessler,HA;Dickinson,GM;Pitrak,DL;Gilman,SC;George,WL;Cohn,SE;Simberkoff,MS
许多感染人类免疫缺陷病毒（HIV）并有肺炎症状的患者根据经验治疗卡氏肺孢子虫（PCP），尽管其他细菌感染（例如，肺结核）和肺卡波西肉瘤可能导致相同的症状。经验性治疗容易造成误诊误治。当评估细胞学确诊与经验治疗的PCP病例的结局时，院内死亡率最重要的预测因素是疾病严重程度和支气管镜检查的使用。未接受支气管镜检查的患者的死亡率高于支气管镜检查阴性或细胞学证实为PCP阳性的患者（22%vs. 11%vs. 14%，P <0.01），尽管疾病严重程度和抗PCP药物治疗的时间没有显著差异。与细胞学确诊的病例相比，在调整疾病严重程度后，未进行支气管镜检查的患者比支气管镜检查阴性的患者更容易死亡（P<0.05）。支气管镜检查的使用可能有助于改善艾滋病毒相关PCP治疗者的结局。
Many patients infected with the human immunodeficiency virus (HIV) with symptoms suggestive of pneumonia are treated empirically forPneumocystis cariniipneumonia (PCP), although other bacterial infections (e.g., tuberculosis) and pulmonary Kaposi's sarcoma may cause identical symptoms. Empiric treatment for PCP may result in misdiagnosis and mistreatment. When the outcomes of cytologically confirmed versus empirically treated PCP cases were evaluated, the most important predictors of in-hospital mortality were severity of illness and use of bronchoscopy. Persons who did not undergo bronchoscopy had higher mortality rates than patients negative by bronchoscopy or cytologically confirmed as positive for PCP (22% vs. 11% vs. 14%,P< .01), although severity of illness and timing of anti-PCP medications did not differ significantly. Compared with cytologically confirmed cases, persons who did not have bronchoscopy were more likely to die than were bronchoscopy- negative patients (P< .05), after adjusting for severity of illness. Bronchoscopy use may have contributed to better outcomes for persons treated for HIV-related PCP.