Utility of Lactate Dehydrogenase vs Radiographic Severity in the Differential Diagnosis of Pneumocystis carinii Pneumonia

Boldt, Michael; Bai, Tony R.

doi:10.1378/chest.111.5.1187

Cited by 30 publications

(16 citation statements)

References 13 publications

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“…Regarding radiographic ®ndings, all patients with P. carinii pneumonia had bilateral interstitial in®ltrates, while most of the bacterial pneumonia showed uni-and bilateral lobar in®ltrates. APACHE II score, serum albumin level, and P. carinii pneumonia diagnosis were found as independent predictive factors of unfavorable outcome on ICU admission, in agreement with previous studies [2,33,34].…”

Section: Discussionsupporting

confidence: 92%

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Reappraisal of the aetiology and prognostic factors of severe acute respiratory failure in HIV patients

Alves

Nicolás²,

Miró³

et al. 2001

Eur Respir J

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The introduction of highly active antiretroviral therapy with protease inhibitors in 1996 has changed the morbidity and mortality of acquired immune deficiency syndrome patients. Therefore, the aetiologies and prognostic factors of human immunodeficiency virus (HIV)-infected patients with life-threatening respiratory failure requiring intensive care unit (ICU) admission need to be reassessed.From 1993 to 1998, we prospectively evaluated 57 HIV patients (mean±sem age 36.5±1.3 yrs) admitted to the ICU showing pulmonary infiltrates and acute respiratory failure.A total of 21 and 30 patients were diagnosed as havingPneumocystis cariniiand bacterial pneumonia, respectively, of whom 13 and eight died during their ICU stay (p=0.01). Both groups of patients had similar age, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and severity in respiratory failure. The number of cases with bacterial pneumonia admitted to ICU decreased after 1996 (p=0.05). Logistic regression analysis showed that (APACHE) II score >17, serum albumin level <25 g·L−1, and diagnosis ofP. cariniipneumonia were the only factors at entry associated with ICU mortality (p=0.02).Patients with bacterial pneumonia are less frequently admitted to the intensive care unit after the introduction of highly active antiretroviral therapy with protease inhibitors in 1996. Compared to the previous series, it was observed that the fewPneumocystis cariniipneumonia patients that need intensive care still have a bad prognosis.

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Section: Discussionsupporting

confidence: 92%

“…The clinical and epidemiological data observed in the present study are consistent with the literature [33]. Regarding radiographic ®ndings, all patients with P. carinii pneumonia had bilateral interstitial in®ltrates, while most of the bacterial pneumonia showed uni-and bilateral lobar in®ltrates.…”

Section: Discussionsupporting

confidence: 91%

Reappraisal of the aetiology and prognostic factors of severe acute respiratory failure in HIV patients

Alves

Nicolás²,

Miró³

et al. 2001

Eur Respir J

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“…Laboratory evaluation usually shows a leucocytosis but leucopenia can occur. Serum lactate dehydrogenase levels are typically normal or mildly elevated [63]. Hypoxaemia may be present [37].…”

Section: Clinical Presentation and Diagnostic Management Of Lower Resmentioning

confidence: 99%

Pyogenic bacterial lower respiratory tract infection in human immunodeficiency virus-infected patients

Mayaud

Parrot²,

Cadranel³

2002

Eur Respir J

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In human immunodeficiency virus (HIV)-infected patients, bacterial lower respiratory tract infections are the most frequent respiratory diseases. They are frequently the first clinical manifestation of HIV infection.The incidence and severity of bacterial lower respiratory tract infections increase with the degree of immunosuppression. At the acquired immune deficiency syndrome (AIDS) stage, the responsible bacteria and clinical presentation may be atypical. Bacterial pneumonia may be fatal, particularly in AIDS patients, and its occurrence is predictive of a reduced survival time.Pneumococcal vaccine is recommended in patients with a CD4 T‐lymphocyte count of >200 cells·mm−3and cotrimoxazole (trimethoprim/sulfamethoxazole) in patients with a CD4 T‐lymphocyte count of <200 cells·mm−3. Unfortunately, such prophylaxis remains insufficiently prescribed and its protective effect is limited.Highly active antiretroviral treatment has dramatically reduced the incidence of lower respiratory tract infection due toPseudomonasaeruginosaand opportunistic bacteria. In contrast, successful highly active antiretroviral therapy slightly decreased the risk of bacterial pneumonia due to usual bacteria, even in patients on successful highly active antiretroviral therapy.

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“…Previous studies addressed the need for simpler tests and strategies to identify patients with a high probability of having PCP to initiate either empiric treatment or aggressive investigation [5,6]. These studies reported that an increase in LDH value had variable specificity and sensitivity for the diagnosis of PCP.…”

Section: Discussionmentioning

confidence: 99%

Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

Afessa

2001

BMC Pulm Med

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Utility of Lactate Dehydrogenase vs Radiographic Severity in the Differential Diagnosis of Pneumocystis carinii Pneumonia

Cited by 30 publications

References 13 publications

Reappraisal of the aetiology and prognostic factors of severe acute respiratory failure in HIV patients

Reappraisal of the aetiology and prognostic factors of severe acute respiratory failure in HIV patients

Pyogenic bacterial lower respiratory tract infection in human immunodeficiency virus-infected patients

Mycobacterial and nonbacterial pulmonary complications in hospitalized patients with human immunodeficiency virus infection: A prospective, cohort study

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