Empirically treated pneumocystis carinii pneumonia in los angeles, chicago, and miami: 1987-1990

Charles L. Bennett, Ronnie D. Horner, Robert A. Weinstein, Harold A. Kessler, Gordon M. Dickinson, David L. Pitrak, Stuart C. Gilman, W. Lance George, Susan E. Cohn, Michael S. Simberkoff, Jeffrey M. Jacobson, Jack A. De Hovitz, Matthew B. Goetz, Martin F. Shapiro

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Many patients infected with the human immunodeficiency virus (HIV) with symptoms suggestive of pneumonia are treated empirically for Pneumocystis carinii pneumonia (PCP), although other bacterial infections (e.g., tuberculosis) and pulmonary Kaposi's sarcoma may cause identical symptoms. Empiric treatment for PCP may result in misdiagnosis and mistreatment. When the outcomes of cytologically confirmed versus empirically treated PCP cases were evaluated, the most important predictors of in-hospital mortality were severity of illness and use of bronchoscopy. Persons who did not undergo bronchoscopy had higher mortality rates than patients negative by bronchoscopy or cytologically confirmed as positive for PCP (22% vs. 11% vs. 14%, P < .01), although severity of illness and timing of anti-PCP medications did not differ significantly. Compared with cytologically confirmed cases, persons who did not have bronchoscopy were more likely to die than were bronchoscopy-negative patients (P < .05), after adjusting for severity of illness. Bronchoscopy rise may have contributed to better outcomes for persons treated for HIV-related PCP.

Original languageEnglish (US)
Pages (from-to)312-315
Number of pages4
JournalJournal of Infectious Diseases
Volume172
Issue number1
DOIs
StatePublished - Jul 1995

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Bennett, C. L., Horner, R. D., Weinstein, R. A., Kessler, H. A., Dickinson, G. M., Pitrak, D. L., Gilman, S. C., George, W. L., Cohn, S. E., Simberkoff, M. S., Jacobson, J. M., De Hovitz, J. A., Goetz, M. B., & Shapiro, M. F. (1995). Empirically treated pneumocystis carinii pneumonia in los angeles, chicago, and miami: 1987-1990. Journal of Infectious Diseases, 172(1), 312-315. https://doi.org/10.1093/infdis/172.1.312