Pneumocystis carnii pneumonia in AIDS--an autopsy report.

Pneumocystis carinii pneumonia (PCP), the most common presenting manifestation in patients with AIDS from western countries, holds the distinction for being the first opportunistic infection that was associated with AIDS. There is marked paucity of clinically diagnosed and pathologically confirmed cases of PCP in India. This case represents the first complete autopsy report of pneumocystis carinii pneumonia inpatient with AIDS from our country. A high index of clinical suspicion and microscopic confirmation is needed to avert mortality due to PCP in patients with AIDS.

Pathology of the heart in acquired immunodeficiency syndrome.

The spectrum of cardiac lesions in patients with acquired immunodeficiency syndrome in India is not described. To determine the extent of involvement of the heart with this disease, an autopsy study of 52 subjects having acquired immunodeficiency syndrome was carried out. Multiple sections were obtained from different anatomical parts of each heart. Forty-eight of the 52 hearts showed subtle microscopic changes, the most common being myocardial atrophy (48 cases), lymphocytic pericarditis (38 cases), fibrinous pericarditis (1 case), pericardial fibrosis (1 case), lymphocytic myocarditis (29 cases) and myocardial fibrosis (7 cases). Cryptococcosis of the heart was noticed in two cases, while in one case toxoplasmic myocarditis was identified. In only one case clinical presentation of cardiac involvement (pericardial effusion) was noted, which indicates that in spite of the presence of significant pathology in the heart, overt cardiac manifestations are infrequently seen in patients with acquired immunodeficiency syndrome.