Bilateral Upper-Lobe Cavitary Pneumocystis carinii Pneumonia in a Patient on Dapsone Prophylaxis
Pneumocystis carinii pneumonia (PCP) presenting as bilateral upper-lobe cavitary disease is rare. Isolated upper-lobe involvement has traditionally been associated with aerosolized pentamidine prophylaxis. Dapsone is a cheap and effective prophylactic agent against P carinii in patients who cannot t...
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| Veröffentlicht in: | The American journal of the medical sciences 1999-02, Vol.317 (2), p.137-139 |
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| container_title | The American journal of the medical sciences |
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| creator | Jawahar, David A. Dama, Sunil Miarrostami, Rameen Sadagdhar, Hamid Anandarao, Nanarao |
| description | Pneumocystis carinii pneumonia (PCP) presenting as bilateral upper-lobe cavitary disease is rare. Isolated upper-lobe involvement has traditionally been associated with aerosolized pentamidine prophylaxis. Dapsone is a cheap and effective prophylactic agent against P carinii in patients who cannot tolerate trimethoprim-sulfamethoxazole. This is a case of a man who presented with bilateral upper-lobe cavitary P carinii pneumonia despite being on dapsone prophylaxis. Bronchoalveolar lavage was negative for P carinii. Transbronchial biopsy was positive for P carinii. The patient improved significantly with radiological resolution on specific treatment for P carinii. PCP should be included in the differential diagnosis of upper-lobe cavitary lung disease, and a transbronchial biopsy should be performed when the diagnosis is suspected. |
| doi_str_mv | 10.1016/S0002-9629(15)40488-4 |
| format | Article |
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Isolated upper-lobe involvement has traditionally been associated with aerosolized pentamidine prophylaxis. Dapsone is a cheap and effective prophylactic agent against P carinii in patients who cannot tolerate trimethoprim-sulfamethoxazole. This is a case of a man who presented with bilateral upper-lobe cavitary P carinii pneumonia despite being on dapsone prophylaxis. Bronchoalveolar lavage was negative for P carinii. Transbronchial biopsy was positive for P carinii. The patient improved significantly with radiological resolution on specific treatment for P carinii. PCP should be included in the differential diagnosis of upper-lobe cavitary lung disease, and a transbronchial biopsy should be performed when the diagnosis is suspected.</description><identifier>ISSN: 0002-9629</identifier><identifier>EISSN: 1538-2990</identifier><identifier>DOI: 10.1016/S0002-9629(15)40488-4</identifier><identifier>PMID: 10037118</identifier><identifier>CODEN: AJMSA9</identifier><language>eng</language><publisher>Hagerstown, MD: Elsevier Inc</publisher><subject>AIDS-Related Opportunistic Infections - diagnostic imaging ; AIDS-Related Opportunistic Infections - prevention & control ; AIDS/HIV ; Anti-Infective Agents - therapeutic use ; Biological and medical sciences ; Cavitation ; Dapsone - therapeutic use ; Dapsone prophylaxis ; Diagnosis, Differential ; Human viral diseases ; Humans ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Pneumonia, Pneumocystis - diagnostic imaging ; Pneumonia, Pneumocystis - prevention & control ; Radiography ; Upper lobe Pneumocystis carinii pneumonia ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. 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Isolated upper-lobe involvement has traditionally been associated with aerosolized pentamidine prophylaxis. Dapsone is a cheap and effective prophylactic agent against P carinii in patients who cannot tolerate trimethoprim-sulfamethoxazole. This is a case of a man who presented with bilateral upper-lobe cavitary P carinii pneumonia despite being on dapsone prophylaxis. Bronchoalveolar lavage was negative for P carinii. Transbronchial biopsy was positive for P carinii. The patient improved significantly with radiological resolution on specific treatment for P carinii. PCP should be included in the differential diagnosis of upper-lobe cavitary lung disease, and a transbronchial biopsy should be performed when the diagnosis is suspected.</description><subject>AIDS-Related Opportunistic Infections - diagnostic imaging</subject><subject>AIDS-Related Opportunistic Infections - prevention & control</subject><subject>AIDS/HIV</subject><subject>Anti-Infective Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cavitation</subject><subject>Dapsone - therapeutic use</subject><subject>Dapsone prophylaxis</subject><subject>Diagnosis, Differential</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pneumonia, Pneumocystis - diagnostic imaging</subject><subject>Pneumonia, Pneumocystis - prevention & control</subject><subject>Radiography</subject><subject>Upper lobe Pneumocystis carinii pneumonia</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0002-9629</issn><issn>1538-2990</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1vEzEQQC1ERUPLTwD5gFA5bOvxrnftE4JAaaVIjQQ9G8ceq6429tbeVM2_77aJCjdOMxq9-XqEvAd2Cgzas1-MMV6plqsTEJ8b1khZNa_IDEQtK64Ue01mL8gheVvKLWPAJdRvyCEwVncAckb-fAu9GTGbnl4PA-ZqkVZI5-Y-jCZv6TLiZp3stoyhUGtyiCHsizEYGiI1dGnGgHGkKdLvZigpIl3mNNxse_MQyjE58KYv-G4fj8j1-Y_f84tqcfXzcv51UVled7JaKe-lcI0VAqRjsmadALCtQKO8Eb6R1sFKeMe9U445OaUCLUDHuReirY_Ip93cIae7DZZRr0Ox2PcmYtoU3Sqh6q5REyh2oM2plIxeDzmsp2c1MP2kVj-r1U_eNAj9rFY3U9-H_YLNao3un66dywn4uAdMsab32UQbyl-ulcB4PWFfdhhONu4DZl3s5M-iCxntqF0K_7nkEbgwlgs</recordid><startdate>199902</startdate><enddate>199902</enddate><creator>Jawahar, David A.</creator><creator>Dama, Sunil</creator><creator>Miarrostami, Rameen</creator><creator>Sadagdhar, Hamid</creator><creator>Anandarao, Nanarao</creator><general>Elsevier Inc</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199902</creationdate><title>Bilateral Upper-Lobe Cavitary Pneumocystis carinii Pneumonia in a Patient on Dapsone Prophylaxis</title><author>Jawahar, David A. ; Dama, Sunil ; Miarrostami, Rameen ; Sadagdhar, Hamid ; Anandarao, Nanarao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2378-b9ff85d4c5518d08307511c65ea9fa5f48cd1b5fd2fd9d0d85fd5ec11722f5563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>AIDS-Related Opportunistic Infections - diagnostic imaging</topic><topic>AIDS-Related Opportunistic Infections - prevention & control</topic><topic>AIDS/HIV</topic><topic>Anti-Infective Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cavitation</topic><topic>Dapsone - therapeutic use</topic><topic>Dapsone prophylaxis</topic><topic>Diagnosis, Differential</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pneumonia, Pneumocystis - diagnostic imaging</topic><topic>Pneumonia, Pneumocystis - prevention & control</topic><topic>Radiography</topic><topic>Upper lobe Pneumocystis carinii pneumonia</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jawahar, David A.</creatorcontrib><creatorcontrib>Dama, Sunil</creatorcontrib><creatorcontrib>Miarrostami, Rameen</creatorcontrib><creatorcontrib>Sadagdhar, Hamid</creatorcontrib><creatorcontrib>Anandarao, Nanarao</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of the medical sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jawahar, David A.</au><au>Dama, Sunil</au><au>Miarrostami, Rameen</au><au>Sadagdhar, Hamid</au><au>Anandarao, Nanarao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bilateral Upper-Lobe Cavitary Pneumocystis carinii Pneumonia in a Patient on Dapsone Prophylaxis</atitle><jtitle>The American journal of the medical sciences</jtitle><addtitle>Am J Med Sci</addtitle><date>1999-02</date><risdate>1999</risdate><volume>317</volume><issue>2</issue><spage>137</spage><epage>139</epage><pages>137-139</pages><issn>0002-9629</issn><eissn>1538-2990</eissn><coden>AJMSA9</coden><abstract>Pneumocystis carinii pneumonia (PCP) presenting as bilateral upper-lobe cavitary disease is rare. Isolated upper-lobe involvement has traditionally been associated with aerosolized pentamidine prophylaxis. Dapsone is a cheap and effective prophylactic agent against P carinii in patients who cannot tolerate trimethoprim-sulfamethoxazole. This is a case of a man who presented with bilateral upper-lobe cavitary P carinii pneumonia despite being on dapsone prophylaxis. Bronchoalveolar lavage was negative for P carinii. Transbronchial biopsy was positive for P carinii. The patient improved significantly with radiological resolution on specific treatment for P carinii. PCP should be included in the differential diagnosis of upper-lobe cavitary lung disease, and a transbronchial biopsy should be performed when the diagnosis is suspected.</abstract><cop>Hagerstown, MD</cop><pub>Elsevier Inc</pub><pmid>10037118</pmid><doi>10.1016/S0002-9629(15)40488-4</doi><tpages>3</tpages></addata></record> |
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| source | MEDLINE; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | AIDS-Related Opportunistic Infections - diagnostic imaging AIDS-Related Opportunistic Infections - prevention & control AIDS/HIV Anti-Infective Agents - therapeutic use Biological and medical sciences Cavitation Dapsone - therapeutic use Dapsone prophylaxis Diagnosis, Differential Human viral diseases Humans Infectious diseases Male Medical sciences Middle Aged Pneumonia, Pneumocystis - diagnostic imaging Pneumonia, Pneumocystis - prevention & control Radiography Upper lobe Pneumocystis carinii pneumonia Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Bilateral Upper-Lobe Cavitary Pneumocystis carinii Pneumonia in a Patient on Dapsone Prophylaxis |
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