1064 course of pulmonary dysfunction in children surviving pneumocystis carinii pneumonitis (pcp): a prospective study

ABSTRACT Twenty-five pulmonary function studies were done serially in 23 children, 7-18 years of age, who had survived the acute stage of PCP and were asymptomatic. Spirometric indices,

expiratory flow rates, pulmonary gas transfer factor (DLCO), blood gases and other clinical variables were assessed a few days befor hospital discharge and at 1-, 3-, 6- and 12-month

intervals. Two patients developed recurrent PCP during follow-up and were studied twice. All but 5 (80%) had pulmonary dysfunction when tested initially. A decrease in DLCO in 17 studies was

the most common abnormality. Restrictive lung disease was seen in 11, an obstructive component in 1, and arterial hypoxemia at rest in 9 cases. Roentgenologic evidence of lung opacities,

seen in 11 studies, was positively correlated (P<0.001) with decreases in DLCO. Arterial hypoxemia was significantly related to intrapulmonary right-to-left shunting (P<0.001) but not

to DLCO indicating the importance of ventilation-perfusion abnormalities in the genesis of hypoxemia in these patients. Serial follow-up studies showed significant improvement in lung

functions within 1 month (P<0.001) and complete resolution by 6 months in all survivors. The recovery was not related to the amount or duration of oxygen therapy or to the need for

mechanical ventilation. Histopathologic studies in 9 patients who died during follow-up or subsequently did not indicate any residual interstitial fibrosis, collagen deposits and

alveolopathy or vascular proliferation. We conclude that PCP in older children commonly does not result in long-lasting pulmonary sequelae. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND

AFFILIATIONS * Cardiopulmonary Disease Service, St. Jude Children's Research Hospital, Memphis, TN Shyamal K Sanyal, William C Mariencheck & Paul W Mackert Authors * Shyamal K

Sanyal View author publications You can also search for this author inPubMed Google Scholar * William C Mariencheck View author publications You can also search for this author inPubMed 

Google Scholar * Paul W Mackert View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE

THIS ARTICLE Sanyal, S., Mariencheck, W. & Mackert, P. 1064 COURSE OF PULMONARY DYSFUNCTION IN CHILDREN SURVIVING PNEUMOCYSTIS CARINII PNEUMONITIS (PCP): A PROSPECTIVE STUDY. _Pediatr

Res_ 15 (Suppl 4), 620 (1981). https://doi.org/10.1203/00006450-198104001-01090 Download citation * Issue Date: 01 April 1981 * DOI: https://doi.org/10.1203/00006450-198104001-01090 SHARE

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