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• W1874366187 abstract "Pneumocystis carinii pneumonia is apparently still rare in the United States, since only seven deaths from this cause have been unequivocally proved. The seventh of these cases, from the John Sealy Hospital, Galveston, Texas, brought to our attention this interesting and serious interstitial plasma-cell pneumonia which we had not heretofore recognized. Pneumocystis carinii pneumonia has been known in Europe only in recent years, reaching epidemic proportions in the last decade. It was first described by Ammich (2) in 1938. An increasing number of cases were subsequently reported in Germany and Switzerland, with rapid spread peripherally from these countries into other European areas. In 1955, 1 case was reported from England. Three cases were reported from Canada in 1956 and from 1957 to 1959 there have been reported 1 case from Connecticut (3), 2 from Oklahoma (11), 1 from Georgia (8), 1 from Arizona (5), and 1 from Louisiana (10). The first recognized case in the United States was reported in 1955 (9) and Pneumocystis carinii may yet present an important problem in this area. The disease occurs endemically or epidemically within hospital nurseries and seems to have a predilection for premature or debilitated infants, although it has been recorded several times in adult subjects. The organism is described as a parasite of controversial taxonomy, and the mode of transmission is unknown. Antemortem diagnosis is difficult. Treatment is unsatisfactory, and mortality ranges from 15 to 100 per cent. Clinical Features The onset of interstitial plasma-cell pneumonia is so insidious that it is difficult to determine. The first signs are usually restlessness, languor, and lack of appetite. Tachypnea and a peculiar cyanosis around the mouth and under the eyes suggest respiratory tract involvement. Generalized grayish cyanosis and dyspnea with sternal retraction and prominent flank movements are seen. Deamer and Zollinger (4) quote Willi as considering the rapid respiratory movement of the lateral abdominal wall the most important clinical finding. Cyanosis may persist even during the administration of oxygen. While cough is not a characteristic feature, it may occur in sudden exhausting attacks. There is usually an inconstant, low-grade fever, or none at all. Rhinitis, diarrhea, and inertia may precede pulmonary involvement by as much as a month. The discrepancy between the severity of dyspnea and the paucity of physical findings is typical, although fine crepitant rales and bronchial breath sounds may be heard over some lung areas. Clinical studies in various European hospitals have shown that many infants have mild attacks which are detected only by routine counts of the respiratory rate along with frequent chest roentgenograms following exposure to the disease. A respiratory rate exceeding 40 to 50 per minute in the sleeping premature infant is regarded with suspicion. Interstitial emphysema develops progressively." @default.
• W1874366187 created "2016-06-24" @default.
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• W1874366187 date "1960-08-01" @default.
• W1874366187 modified "2023-09-26" @default.
• W1874366187 title "Pneumocystis Carinii Pneumonia" @default.
• W1874366187 doi "https://doi.org/10.1148/75.2.257" @default.
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