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KMID : 0351219940260010087
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Korean Journal of Infectious Diseases
1994 Volume.26 No. 1 p.87 ~ p.91
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A Case with Peumocystic Carinu Pneumonia in acquired Immunodeficiency Syndrome
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최정은
김양수/정해혁/고윤석/문희범/김원동/김대원/배직현/김유겸
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Abstract
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Pneumocystis carinii pneumonia (PCP) is the most common and serious opportunistic infection occuring in patients with the acquired immuno deficiency syndrome (AIDS). It is estimated to occur in approximately 70-80% of patients with AIDS and
contributes
significantly to the overall morbidity and mortality of those patients. Because PCP is amenable to antimicrobial treatment such as Trimethoprim-sulfamethoxazole(bactrim), sensitive and accurate diagnosis of PCP is important. Clinical
presentations
and
chest radiographs are helpful in the diagnosis of PCP, but the demostration of the organism is essential for definite diagnosis. Recently, adjunctive therapy with corticosterold for ALDS associated pneumocystis carinii pneumonia has been
advocated
as a
means to prevent morbidity and mortality.
We report a case of pneumocystis carinii pneumonia in a patient with AIDS. A 33-year-old female patient was admitted because of dry cough and dyspnea. Physical examination was unremarkable. On arterial blood gas analysis, PaO2 was 24mmHg. Chest
X-ray
showed diffuse interstitial infiltration in both lung fields. Immediate ventilatory assistance with mechanical ventilator was provided for respiratory failure. On the second hospital day, bronchoalveolar lavage(BAL) was performed. The BAL fluid
was
examined with Calcoflour White staining, which revealed cysts of pneumocystis carinii. The test for anti-HIV antibody by ELISA and Western blot showed positive result. Peripheral CD4 count was 20/mm3. She was diagnosed asa AIDS complicated with
PCP.
Trimethoprim-sulfamethoxazole was started immediately and methylprednisolone was added 2 days later and then tapered for next 3 weeks.
On 17th hospital day, clinical and radiological presentions were improved and was weaned from mechanical ventilation. On 25th hospital day, she was recovered from PCP completely.
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KEYWORD
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