Pneumocystis carinii in bronchogenic carcinoma compared to other immunocompromised cancer patients using immunofluorescence and immunoperoxidase techniques

ABSTRACT

Indirect immunofluorescence [IFL] assay was used concomitantly with immunoperoxidase stain for the diagnosis of Pneumocystis carinii in 54 cancer patients with respiratory illness. The specimen analyzed was bronchoalveolar lavage fluid [BALF] in 27 patients complaining mainly of blood-tinged sputum for a period of 3-6 months with cough [group one]. Of these patients, 20 were documented by bronchoscopy and histopathology to be bronchogenic carcinoma [subgroup 1A]. Induced sputum was the test specimen in another 27 cancer patients with cough and expectoration for more than one month during receiving their chemotherapy [group two]. In subgroup 1A, eight BALF specimens showed positivity for P. carinii by both techniques. All positive cases for P. Carinii were belonging to subgroup 1A, i.e. proved bronchogenic carcinoma. The immunoperoxidase technique was slightly more specific and as sensitive as IFL. The IFL gave two false positive results as P. carinii cysts were similar to fungi under the fluorescent microscope. On the other hand, only one patient in group two was positive for P. carinii