Skip Navigation
Menu
Letters |1 December 1996

Outpatient Management of HIV-Related Pneumonia

Henry Masur, MD; James H. Shelhamer, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • National Institutes of Health, Bethesda, MD 20892.
×
FULL TEXT
IN RESPONSE:
Dr. Becker raises two issues that were not explicitly addressed in our editorial. First, if the result of an induced-sputum examination is negative for P. carinii, what diagnosis is likely? Second, if the result of an induced-sputum examination is negative for P. carinii, what diagnostic procedures should be used?
Regarding the first issue, we believe that at many institutions, induced sputum examination has a high sensitivity for P. carinii pneumonia in patients who are and are not receiving prophylaxis for P. carinii pneumonia (sensitivity, >60% and >90%, respectively) [1]. However, we do not agree that a negative result of induced-sputum examination in this setting makes other pulmonary diagnoses substantially more likely than a diagnosis of P. carinii pneumonia. Huang and colleagues [2] reported that in patients who have HIV infection, low CD4 counts, a clinical picture typical of P. carinii pneumonia, and a negative result of an induced-sputum examination, the most likely diagnosis is P. carinii pneumonia. In that study [2] (which was done at an institution with considerable experience assessing induced-sputum samples), 192 of 602 (31%) patients with negative results of induced-sputum examinations were found to have P. carinii pneumonia at bronchoscopy. This diagnosis was substantially more common than that of M. tuberculosis infection (<5%) or fungal infection (<5%).
FULL TEXT
PDF
Not Available
Citations
Citation

Masur H, Shelhamer JH. Outpatient Management of HIV-Related Pneumonia. Ann Intern Med. ;125:938–939. doi: 10.7326/0003-4819-125-11-199612010-00018

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 1996;125(11):938-939.

DOI: 10.7326/0003-4819-125-11-199612010-00018

0 Citations
CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×