PNEUMOCYSTIS CARINII BY INDUCED SPUTUM IN IMMUNOSUPPRESSED PEDIATRIC PATIENTS

儿童HIV感染和其他免疫抑制的患者 卡氏肺孢子虫肺炎易患疾病 支气管镜联合支气管肺泡灌洗在技术上可能更 在儿科患者中很难执行。正因为如此，一个 必须有安全可靠的替代诊断方法 下定决心。基于我们成人的数据，在这些数据中诱导痰 被证明是一个安全和高度敏感的程序，我们已经进行了 一项前瞻性评价诱痰治疗的临床应用 儿童卡氏肺炎性肺炎的诊断。一种类似的超声波 使用高渗氯化钠雾化技术 咳痰、口咽部或鼻咽部吸痰 受雇的。数据表明，卡氏肺孢子虫可以通过 这项技术适用于年仅一岁的儿童。这项技术是一种 非常安全和有效的替代支气管镜检查的儿童。 这项研究的初步数据已经发表在 儿科。该项目正在进行中，一个主要目标是进一步 改进采样技术，提高灵敏度。 最初手稿之后的诊断数据已经被 已收集，目前正在审查中。这些数据正在被 从技术改进的角度分析诊断成品率， 敏感性和特异性，以及患者的安全性。目标和 本项目的意义在于优化诊断 该技术对卡氏肺孢子虫的敏感性，并修改 技术尽可能地限制患者的发病率。

Pediatric patients with HIV infection and other immunosuppressive disorders are susceptible to Pneumocystis carinii pneumonia Bronchoscopy with bronchoalveolar lavage may be technically more difficult to perform in pediatric patients. Because of this, an alterative diagnostic method which was safe and reliable had to be determined. Based on our adult data in which sputum induction was shown to be a safe and highly sensitive procedure, we have undertaken a prospective assessment of the utility of sputum induction for the diagnosis of P. carinii pneumonia in children. A similar ultrasonic nebulization technique using hypertonic sodium chloride with either expectoration, oropharyngeal or nasopharangeal suctioning has been employed. Data indicate that P. carinii can be reliably diagnosed by this technique in children as young as one year. The technique is a very safe and effective alternative to bronchoscopy for children. Initial data from this study have appeared in the Journal of Pediatrics. The project is ongoing, and a major goal is to further improve the sampling technique in order to increase sensitivity. Diagnostic data subsequent to the initial manuscript have been collected and are currently being reviewed. The data are being analyzed in terms of technical improvements diagnostic yield, sensitivity and specificity, and patient safety. The goals and significance of this project are to optimize the diagnostic sensitivity for P. carinii of this technique and to modify the technique as possible to limit patient morbidity.