Disseminated infection ofPneumocystis carinii in a patient with the acquired immunodeficiency syndrome

Abstract

This report describes the histopathology of a disseminated Pneumocystis carinii infection in a 24-year-old Japanese male haemophiliac diagnosed as having the acquired immunodeficiency syndrome. He developed respiratory symptoms, and Pneumocystis carinii pneumonia was confirmed by transbronchial lung biopsy. On the 70th day of hospitalization the patient died. Autopsy findings revealed Pneumocystis carinii not only in the lungs but also in the stomach, jejunum, ileum, colon, mesoappendix, abdominal lymph nodes, diaphragm, and thyroid gland.

Pneumocystis carinii in fna of the thyroid

“…l5 Rapid diagnosis and intensive pulmonary therapy have decreased the death rate in acute PCP by 70-85%. l6 Without maintenance therapy, PCP recurs in as many as 60% of these patients within 1 yr. 4 Survivors of one episode of PCP lack immunity to reinfection. Moreover, they are at increased risk for reinfection by PC, reinfection being complicated by prior injury to the lungs (manifest by histologic changes as well as decreased pulmonary function) and varying degrees of intolerance to effective medications.…”

“…3,8*13,14 Very few cases of PC thyroiditis have been reported. [3][4][5]10,13,[22][23][24] Most were discovered at autopsy in patients with widely disseminated infection. We know of only 1 case in which the diagnosis was made on FNA of the thyroid.…”

“…These reports include patients without clinical pneumonia. [4][5][6][7][8][9][10] It has been suggested that the increase in EPC is due, at least in part, to widespread use of prophylactic and therapeutic regimens directed only against pulmonary disease. a,' '- 14 Our patient had Pneumocystis carinii (PC) of the thyroid diagnosed by fine-needle aspiration (FNA).…”

<i>Pneumocystis carinii</i> Thyroiditis Diagnosis by Fine Needle Aspiration Cytology

“…1,5 Consequently, with the recent increase in the number of AIDS patients, the incidence of PCP has also increased. 12 The PC pathogen causes interstitial pneumonitis in about 60% of these individuals. The infection is an initial manifestation of the disease process, and 80% of those affected will develop one or more episodes during the course of the disease.…”

“…Systemic pneumocystosis most often involves the lymph nodes, stomach, spleen, liver, skin, pancreas, choroid and eyes. [1][2][3]6,11,12,15 Isolated lesions containing PC have also been identified in the thyroid. 3,7,9,10,13,14,[16][17][18] This report describes a rare case of PC thyroiditis in a patient with the acquired immunodeficiency syndrome (AIDS) and no prior PC infection.…”