Mechanical Ventilation for Pneumocystis сarinii Pneumonia in Patients With the Acquired Immunodeficiency Syndrome: Results
Twenty-nine men and four women required tracheal intubation and MV for ARF secondary to PCP (Table 1). Pneumocystis carinii pneumonia was the presenting illness in nine cases. The other patients, known as HIV infected, were not being seen regularly by a physician (n = 6), were asymptomatic (n = 7), or were suffering from clinical manifestations (n= 11): AIDS-related complex (n=l), Kaposi’s sarcoma (n = 4), recurrent cutaneous herpes or shingles (n = 2), herpetic esophagitis (n = l), pulmonary tuberculosis (n = l), pulmonary aspergillosis (n = l), HIV encephalitis (n = 1), cryptosporidiosis (n = 1), or oral hairy leuko-plasia (n = 1). Five patients were receiving zidovudine when PCP was diagnosed.
It was the first episode of PCP in all patients but one. Three received primary prophylaxis, either with monthly pentamidine aerosols (n = 2) or with daily cotrimoxazole (n = l). One patient presented with a second episode of PCP 6 months after the first and despite monthly pentamidine aerosols by way of secondary prophylaxis.
The clinical signs of PCP were as follows: dyspnea (n = 33), dry cough (n = 21), temperature above 38°C (n = 28), weight loss (n = 7), fatigue (n = 7), and anorexia (n = 4). Pulmonary radiographs showed diffuse interstitial and alveolar opacities in every case. canadian pharmacy mall