<i>Pneumocystis carinii</i> Pneumonia

Abstract

Seven patients with documented Pneumocystis carinii pneumonia are presented. Six of these had underlying chronic diseases and had been on long-term prednisone therapy. Five had malignant disease of the reticuloendothelial system. The diagnosis of pneumocystosis was suspected antemortem in two patients, and treatment was instituted with pentamidine isethionate. In both cases the duration of treatment was short so that full evaluation of the therapeutic efficacy of pentamidine could not be made. Predisposing factors, presenting clinical and roentgenographic features of the disease, and attempts at diagnosis and therapy are discussed. The need for vigorous attempts at early definitive diagnosis is stressed. At present, lung biopsy appears to be the most reliable diagnostic procedure. The effectiveness of pentamidine isethionate in treating clinical Pneumocystis carinii pneumonia can be evaluated only by early institution and adequate trial of therapy in patients with an established diagnosis.