ABSTRACT
Excessive bleeding is a major concern during the administration of thrombolytic therapy. Although the great majority of these events occur at sites of vascular interruption, major gastrointestinal, retroperitoneal, genitourinary, and central nervous system hemorrhage are known to occur. We present a patient who developed spontaneous pulmonary hemorrhage during thrombolytic therapy. Lack of recognition that the lungs too may be a site of spontaneous hemorrhage during thrombolytic therapy may lead to a considerable diagnostic and therapeutic delay. Pulmonary hemorrhage should be considered in the differential diagnosis of patients who receive thrombolytic therapy in whom new roentgenographic pulmonary infiltrates present accompanied by decreases in hematocrit value.
Subject(s)
Coronary Thrombosis/drug therapy , Hemoptysis/chemically induced , Thrombolytic Therapy/adverse effects , Urokinase-Type Plasminogen Activator/adverse effects , Adult , Coronary Angiography , Coronary Thrombosis/complications , Hemoptysis/diagnostic imaging , Humans , Lung/diagnostic imaging , Middle Aged , Myocardial Infarction/complications , Myocardial Infarction/drug therapyABSTRACT
Because Pneumocystis carinii pneumonia (PCP) is so common among patients infected with the human immunodeficiency virus-1 (HIV-1), a quick, simple test to evaluate for its presence or absence would be helpful. We report our results on the role of an exercise blood gas test as a useful procedure for the detection of Pneumocystis pneumonia in patients with respiratory symptoms who have or who are at risk for developing the acquired immunodeficiency syndrome (AIDS). Results show that a normal exercise test, as defined in the study and in our patient population, eliminated PCP from the differential diagnosis. An abnormal test was most useful in separating out a group of patients who urgently needed a diagnosis because PCP was a likely possibility. There were no significant complications associated with this test.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Exercise Test , Oxygen/blood , Pneumonia, Pneumocystis/diagnosis , Adult , Female , Humans , Male , Pneumonia, Pneumocystis/blood , Pneumonia, Pneumocystis/complications , Predictive Value of Tests , Pulmonary Diffusing Capacity , Sensitivity and SpecificityABSTRACT
We report a case of endobronchial Pneumocystis carinii infection in a patient who most likely had the acquired immune deficiency syndrome (AIDS). Although many unusual manifestations of Pneumocystis pneumonia have been reported in patients with AIDS, this is the first case of P carinii presenting as an endobronchial mass.
