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Dtsch Med Wochenschr. 1996 Jan 26;121(4):83-9.

[HIV-associated Pneumocystis carinii pneumonia, primary pentamidine inhalation prophylaxis notwithstanding. Are there differences with Pneumocystis carinii pneumonia without prophylaxis?].

[Article in German]

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  • 1Medizinische Universitätsklinik und Poliklinik sowie Radiologische Universitätsklinik Bonn.

Abstract

OBJECTIVE:

To study the effect of pentamidine aerosol inhalation, known to be effective and well tolerated in the primary prevention of HIV-associated Pneumocystis carinii pneumonia (PCP), on the severity, on clinical and radiological findings and prognosis of break-through PCP.

PATIENTS AND METHODS:

Data were obtained from the case notes of 17 men (mean age 36 [23-55] years) with HIV-associated PCP, treated between 1989 and 1994, who had received primary prophylaxis with pentamidine aerosol. During the same period 42 patients with HIV-associated PCP but no pentamidine prophylaxis (39 men, three women; mean age 36 [21-67] years) were also treated. Bronchoalveolar lavage of the most affected segment was performed. Diagnostic measures and treatment remained constant during the period of observation.

RESULTS:

The clinical presentation was the same in the two groups. There was also no difference between them regarding sensitivity to the lavage (94 and 98%). However, infiltration of the upper segments was significantly more common in the prophylaxis group (90 and 43%; P < 0.02). There was no statistically significant difference between the two groups in death rate (13 and 7%) and the long-term prognosis after PCP (survival time 18 and 24 months, respectively).

CONCLUSION:

Primary prophylaxis of PCP had no significant effect other than altering the distribution pattern of the pneumonic infiltrates towards the apical segments.

PMID:
8631243
[PubMed - indexed for MEDLINE]
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