PNEUMOCYSTIS CARINII BY INDUCED SPUTUM IN IMMUNOSUPPRESSED PEDIATRIC PATIENTS

HIV感染和其他免疫抑制的儿科患者 易患卡氏肺孢子虫肺炎 支气管镜检查和支气管肺泡灌洗可能在技术上更 难以在儿科患者中进行。正因为如此， 安全可靠的替代诊断方法必须 测定根据我们的成人数据，其中痰诱导是 这是一个安全和高度敏感的程序，我们已经采取了 对痰诱导在治疗慢性阻塞性肺疾病中的效用进行前瞻性评估， 小儿卡氏肺孢子虫肺炎的诊断类似的超声波 使用高渗氯化钠雾化技术， 咳痰、口咽或鼻咽喉吸痰， 就业。数据表明，卡氏肺孢子虫可以可靠地诊断， 这种技术在一岁的孩子身上。该技术是一种 是儿童支气管镜检查的一种非常安全有效的替代方法。 这项研究的初步数据发表在《生物医学杂志》上。 儿科.该项目正在进行中，主要目标是进一步 改进取样技术，以提高灵敏度。 最初手稿之后的诊断数据已经 已收集并正在审查中。数据正在被 从技术改进诊断率的角度分析， 敏感性和特异性以及患者安全性。的目标和 该项目的意义是优化诊断 敏感性卡氏肺孢子虫的这种技术，并修改 尽可能减少患者发病率。

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.