Document Detail

Pneumocystis carinii pneumonia in critically ill patients with malignancy: a descriptive study.
MedLine Citation:
PMID:  12355379     Owner:  NLM     Status:  MEDLINE    
There are few data on Pneumocystis carinii pneumonia (PCP) in critically ill human immunodeficiency virus (HIV)-negative patients. Improved knowledge of the presenting symptoms of and prognostic factors for PCP may help to reduce the high mortality rate associated with PCP in such patients. We retrospectively studied 39 consecutive patients with acute PCP-related respiratory failure and malignancy who were treated at 2 intensive care units (ICUs) during a 10-year period. Univariate logistic regression identified the following 8 predictors of mortality at 30 days after patient admission to the ICU (30-day mortality rate, 33%): complete remission of the malignancy (odds ratio [OR], 0.18), receipt of >1 course of antimalignancy chemotherapy (OR, 17.2), involvement of 4 lobes noted on a chest radiograph (OR, 5), >15% neutrophils in bronchoalveolar lavage [BAL] fluid specimens (OR, 6), Organ System Failure score (OR, 7.33), Simplified Acute Physiology Score II (OR, 1.12), and the need for either mechanical ventilation (OR, 63) or vasopressors (OR, 25.9). Studies are needed to determine whether aggressive monitoring and treatment of patients with >15% neutrophils in BAL fluid specimens can improve the outcome of critically ill patients with malignancy and PCP.
J R Zahar; M Robin; E Azoulay; F Fieux; G Nitenberg; B Schlemmer
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Publication Detail:
Type:  Journal Article     Date:  2002-09-23
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  35     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-30     Completed Date:  2002-10-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  929-34     Citation Subset:  IM    
Intensive Care Department, Institut Gustave-Roussy, Paris, France.
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MeSH Terms
Acute Disease
Critical Illness
Middle Aged
Neoplasms / complications*,  radiography
Pneumonia, Pneumocystis / etiology*,  radiography
Retrospective Studies

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