Sputum Induction for Diagnosis of Pneumocystis Carinii Pneumonia

Leigh, T R; Hume, C.; Gazzard, Brian; Parsons, P.; Husain, O. A. N.; Collins, J.V.

doi:10.1016/s0140-6736(89)90382-6

Cited by 83 publications

(37 citation statements)

References 2 publications

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“…It is interesting to point out that in the diagnosis of P. carinii pneumonia, induced sputum had a very poor yield (12%). These results are not in accordance with previous reports (2,19) showing that induced sputum was a reliable noninvasive means of diagnosing P. carinii pneumonia. In the present study, only 1 out of 23 cases was diagnosed by this technique.…”

Section: Discussioncontrasting

confidence: 99%

Pulmonary Infiltrates in Immunosuppressed Patients: Analysis of a Diagnostic Protocol

Danés¹,

González-Martín²,

Pumarola³

et al. 2002

J Clin Microbiol

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A diagnostic protocol was started to study the etiology of pulmonary infiltrates in immunosuppressed patients. The diagnostic yields of the different techniques were analyzed, with special emphasis on the importance of the sample quality and the role of rapid techniques in the diagnostic strategy. In total, 241 patients with newly developed pulmonary infiltrates within a period of 19 months were included. Noninvasive or invasive evaluation was performed according to the characteristics of the infiltrates. Diagnosis was achieved in 202 patients (84%); 173 patients (72%) had pneumonia, and specific etiologic agents were found in 114 (66%). Bronchoaspirate and bronchoalveolar lavage showed the highest yields, either on global analysis (23 of 35 specimens [66%] and 70 of 134 specimens [52%], respectively) or on analysis of each type of pneumonia. A tendency toward better results with optimal-quality samples was observed, and a statistically significant difference was found in sputum bacterial culture. Rapid diagnostic tests yielded results in 71 of 114 (62.2%) diagnoses of etiological pneumonia.

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Section: Discussioncontrasting

confidence: 99%

Pulmonary Infiltrates in Immunosuppressed Patients: Analysis of a Diagnostic Protocol

Danés¹,

González-Martín²,

Pumarola³

et al. 2002

J Clin Microbiol

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“…Eleven studies were excluded because bronchoscopy with BAL was performed only in subsets of patients (usually in patients with negative induced sputum results) [6,16,46,51,[55][56][57][58][59][60][61]. Fifteen studies (seven case-control [48,[62][63][64][65][66][67] and eight retrospective and/or nonconsecutive [51,[68][69][70][71][72][73][74]) were excluded on the basis of design and/or because they did not permit direct comparison of accuracy for every individual in the sample.…”

Section: Appendixmentioning

confidence: 99%

Meta-analysis of diagnostic procedures for Pneumocystis carinii pneumonia in HIV-1-infected patients

Cruciani¹,

Marcati²,

Malena³

et al. 2002

European Respiratory Journal

102

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Sputum induction is a simple and noninvasive procedure for Pneumocystis carinii pneumonia (PCP) diagnosis in human immunodeficiency virus-1-positive patients, although less sensitive than bronchoalveolar lavage (BAL). In order to obtain an overview of the diagnostic accuracy of sputum induction, a systematic review and meta-analysis of studies reporting the comparative sensitivity and specificity of BAL (the "gold standard") and sputum induction was performed.The odds ratio and related 95% confidence interval were calculated using summary receiving operating characteristic curves as well as fixed-effect and random-effect models. Based on pooled data, the negative and positive predictive values were calculated for a range of PCP prevalence using a Bayesian approach.Seven prospective studies assessed the comparative accuracy of BAL and sputum induction. On the whole, sputum induction demonstrated 55.5% sensitivity and 98.6% specificity. The sensitivity of sputum induction was significantly higher with immunofluorescence than with cytochemical staining (67.1 versus 43.1%). In settings of 25-60% prevalence of PCP, the positive and negative predictive values ranged 86-96.7 and 66.2-89.8, respectively, with immunofluorescence, and 79-94.4 and 53-83.5% with cytochemical staining.In conclusion, in a setting of low prevalence of Pneumocystis carinii pneumonia, sputum induction, particularly with immunostaining, appears to be adequate for clinical decision-making. Eur Respir J 2002; 20: 982-989.

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“…Während die Untersuchung von Sputa wenig ergiebig ist, können durch die Induktion von Reizsputa mit hypertoner Kochsalzlösung Proben gewonnen werden, die bei 51 HIV-infizierten Patienten eine Sensitivität bezüglich PcP von 94,7 ergaben [10]. Sputa können mittels Immunfluoreszenz untersucht werden.…”

Section: Diagnose Der Pcpunclassified

Pneumocystis-jiroveci-Pneumonie (PcP) bei Patienten mit rheumatologischen Erkrankungen: Fallbeschreibung und Review

Bertisch¹,

Ruef²

2006

Z. Rheumatol.

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Sputum Induction for Diagnosis of Pneumocystis Carinii Pneumonia

Cited by 83 publications

References 2 publications

Pulmonary Infiltrates in Immunosuppressed Patients: Analysis of a Diagnostic Protocol

Pulmonary Infiltrates in Immunosuppressed Patients: Analysis of a Diagnostic Protocol

Meta-analysis of diagnostic procedures for Pneumocystis carinii pneumonia in HIV-1-infected patients

Pneumocystis-jiroveci-Pneumonie (PcP) bei Patienten mit rheumatologischen Erkrankungen: Fallbeschreibung und Review

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