Abstract
Thirteen HIV infected patients with pneumonitis (9/13, less than 1 year of age) underwent 16 invasive diagnostic procedures to determine the etiology of their pulmonary disease. Procedures were: Open lung biopsy (OLB) in 7 patients (one patient had 2 OLBs), bronchial lavage (BL) in 7 patients and bronchoscopy in 1 patient. OLB was diagnostic 8/8 times, (6 were PCP and 2 were lymphoid interstitial pneumonia). OLB was associated with chest tube placement, continued intubation and ventillation in all 8 patients and two patients had dramatic deterioration in respiratory status at the time of OLB. 2/8 patients died, one related to PCP. Bronchoscopy was non-diagnostic in the one patient. This patient who had bronchoscopy developed laryngospasm requiring intubation and ventilatory support. Because of the morbidity associated with these procedures, in November, 1985, we began performing BL through an endotracheal tube by instilling and suctioning 10-15 cc's of saline through a suction catheter wedged in a small bronchus. The lavage material was cytocentrif uged and stained with Grocott and Diff Quik staining methods. 5/7 specimens were positive for PCP. In the 2 which were negative, PCP was diagnosed by OLB within 24 hours in 1 patient and the second patient had no evidence of PCP at autopsy, 4/7 were intubated, 2 prior to lavage for worsening respiratory status and 3/7 subsequently died, 1 of these deaths was related to PCP. BL is a successful and less invasive alternative for the diagnosis of PCP. It's use as the initial diagnostic procedure for pneumonitis may obviate the need for OLB.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lawrence, R., Horwitz, D., Barrow, K. et al. PNEUMOCYST1S CARINII PNEUMONIA IN CHILDREN WITH HIV INFECTION. Pediatr Res 21 (Suppl 4), 329 (1987). https://doi.org/10.1203/00006450-198704010-00969
Issue Date:
DOI: https://doi.org/10.1203/00006450-198704010-00969