RESUMO
A case of Pneumocystis carinii pneumonia in a patient without an underlying immunosuppressing condition is reported, and 12 other previously reported cases are reviewed. When compared with Pneumocystis carinii pneumonia in association with AIDS and in other immunosuppressing conditions, Pneumocystis carinii pneumonia in patients without predisposing conditions resembles more closely that seen in immunosuppressing conditions other than AIDS.
Assuntos
Imunocompetência , Pneumonia por Pneumocystis/tratamento farmacológico , Pneumonia por Pneumocystis/imunologia , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Seguimentos , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Pneumonia por Pneumocystis/diagnóstico , Medição de Risco , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Six cases of zygomycosis that were diagnosed at Hamad Medical Corporation over an eleven-year period are retrospectively reviewed. All patients had at least one predisposing condition. Renal transplant and diabetes mellitus were the most common predisposing conditions. Sites of involvement were pulmonary in two patients, rhinocerebral two, rhino-orbital, and cutaneous in one each. The clinical features in patients with rhinocerebral and rhino-orbital involvement were very suggestive of the diagnosis, while patients with pulmonary and cutaneous involvement, the disease was not suspected and was only made after the histopathology or culture results were available. Diagnosis was made premortum in all patients. Diagnosis was confirmed by histopathology in three patients and by culture in the other three. Five of the six patients died. Poor outcome correlated with rhinocerebral and pulmonary involvement, while cutaneous disease was associated with favorable outcome. Therapy with amphotericin B, surgical debridement, and correction of the underlying predisposing condition offers the best chance for survival.
