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Lookup NU author(s): Dr Janet Berrington,
Dr Terence Flood,
Dr Mario Abinun,
Dr Angela Galloway,
Professor Andrew Cant
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Background-Pneumocystis carinii is an important pathogen in immunodeficiency but may be an unrecognised cause of respiratory compromise. Objectives-To ascertain the incidence of P carinii pneumonia (PCP) at presentation of severe combined deficiency (SCID), whether it had been diagnosed, and the effect of treatment on outcome. Setting-The supraregional paediatric bone marrow transplant unit for primary immunodeficiencies at Newcastle General Hospital. Methods-Retrospective case note review of infants referred with a diagnosis of SCID from 1992 to 1998. Results-Ten of 50 infants had PCP at presentation; only one was diagnosed before transfer. Eight were diagnosed by bronchoalveolar lavage and two by lung biopsy. In only one was P carinii identified in nasophapyngeal secretions. Five required ventilation for respiratory failure but all were successful treated with co-trimoxazole and methylprednisolone with or without nebulised budesonide. Nine survived to bone narrow transplantation and four are long term survivors after bone marrow transplantation; no deaths were related to PCP. Conclusions-PCP is a common presenting feature of SCID but is rarely recognised. Bronchoalveolar lavage or lung biopsy are needled for diagnosis. Treatment with co-trimoxazole is highly successful.
Author(s): Berrington JE, Flood TJ, Abinun M, Galloway A, Cant AJ
Publication type: Article
Publication status: Published
Journal: Archives of Disease in Childhood
ISSN (print): 0003-9888
ISSN (electronic): 1468-2044
Publisher: BMJ Publishing Group Ltd