Abstract
Three HIV positive subjects presented with symptoms and radiographic changes suggestive of Pneumocystis carinii pneumonia. Methenamine silver staining of bronchoscopic alveolar lavage (BAL) fluid was negative (from one sample in one patient and two samples in the other two patients). Open lung biopsy was performed because of uncertain clinical progress and diagnosis; all three patients were found to have multiple pulmonary granulomata encasing numerous P carinii organisms. DNA amplification, using P carinii specific oligonucleotides, was performed on stored bronchoscopic BAL samples. P carinii specific amplification product was detected by ethidium bromide staining after electrophoretic separation on agarose gel in one case, and by the more sensitive technique of oligohybridisation in all three cases. In granulomatous P carinii pneumonia organisms are rarely identified in bronchoscopic alveolar lavage samples using histochemical staining, but are detectable by DNA amplification, although not at levels which can be readily distinguished from low, subclinical infection.
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Selected References
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- Blumenfeld W., Basgoz N., Owen W. F., Jr, Schmidt D. M. Granulomatous pulmonary lesions in patients with the acquired immunodeficiency syndrome (AIDS) and Pneumocystis carinii infection. Ann Intern Med. 1988 Sep 15;109(6):505–507. doi: 10.7326/0003-4819-109-6-505. [DOI] [PubMed] [Google Scholar]
- Foley N. M., Griffiths M. H., Miller R. F. Histologically atypical Pneumocystis carinii pneumonia. Thorax. 1993 Oct;48(10):996–1001. doi: 10.1136/thx.48.10.996. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hartz J. W., Geisinger K. R., Scharyj M., Muss H. B. Granulomatous pneumocystosis presenting as a solitary pulmonary nodule. Arch Pathol Lab Med. 1985 May;109(5):466–469. [PubMed] [Google Scholar]
- Klein J. S., Warnock M., Webb W. R., Gamsu G. Cavitating and noncavitating granulomas in AIDS patients with Pneumocystis pneumonitis. AJR Am J Roentgenol. 1989 Apr;152(4):753–754. doi: 10.2214/ajr.152.4.753. [DOI] [PubMed] [Google Scholar]
- Peters S. E., Wakefield A. E., Banerji S., Hopkin J. M. Quantification of the detection of Pneumocystis carinii by DNA amplification. Mol Cell Probes. 1992 Apr;6(2):115–117. doi: 10.1016/0890-8508(92)90055-3. [DOI] [PubMed] [Google Scholar]
- Pitkin A. D., Grant A. D., Foley N. M., Miller R. F. Changing patterns of respiratory disease in HIV positive patients in a referral centre in the United Kingdom between 1986-7 and 1990-1. Thorax. 1993 Mar;48(3):204–207. doi: 10.1136/thx.48.3.204. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wakefield A. E., Guiver L., Miller R. F., Hopkin J. M. DNA amplification on induced sputum samples for diagnosis of Pneumocystis carinii pneumonia. Lancet. 1991 Jun 8;337(8754):1378–1379. doi: 10.1016/0140-6736(91)93062-e. [DOI] [PubMed] [Google Scholar]
- Wakefield A. E., Miller R. F., Guiver L. A., Hopkin J. M. Oropharyngeal samples for detection of Pneumocystis carinii by DNA amplification. Q J Med. 1993 Jun;86(6):401–406. [PubMed] [Google Scholar]
- Wakefield A. E., Pixley F. J., Banerji S., Sinclair K., Miller R. F., Moxon E. R., Hopkin J. M. Amplification of mitochondrial ribosomal RNA sequences from Pneumocystis carinii DNA of rat and human origin. Mol Biochem Parasitol. 1990 Nov;43(1):69–76. doi: 10.1016/0166-6851(90)90131-5. [DOI] [PubMed] [Google Scholar]
- Wakefield A. E., Pixley F. J., Banerji S., Sinclair K., Miller R. F., Moxon E. R., Hopkin J. M. Detection of Pneumocystis carinii with DNA amplification. Lancet. 1990 Aug 25;336(8713):451–453. doi: 10.1016/0140-6736(90)92008-6. [DOI] [PubMed] [Google Scholar]