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1996-02-26
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Document 0097
DOCN M9620097
TI Diagnosis of Pneumocystis carinii pneumonia by bronchoalveolar lavage in
AIDS patients. Comparison of Diff-Quik, fungifluor stain, direct
immunofluorescence test and polymerase chain reaction.
DT 9602
AU Armbruster C; Pokieser L; Hassl A; IInd Medical Department, University
of Vienna, Austria.
SO Acta Cytol. 1995 Nov-Dec;39(6):1089-93. Unique Identifier : AIDSLINE
MED/96074702
AB OBJECTIVE: To assess the sensitivity, specificity and accuracy of
Diff-Quik, fungifluor stain, the direct immunofluorescence test (DIFT)
and the polymerase chain reaction (PCR) in the diagnosis of Pneumocystis
carinii pneumonia (PCP) in human immunodeficiency virus (HIV)-infected
patients. STUDY DESIGN: From December 1992 through November 1993, 112
bronchoalveolar lavage fluid (BALF) samples were obtained from 80
HIV-infected patients. BALF samples were processed for cytologic and
microbiologic analysis and for PCR. Cytologic examination was carried
out on Diff-Quik-stained cytocentrifuge preparations and with
May-Grunwald-Giemsa staining and fungifluor staining. For diagnosis of
PC infection, DIFT and PCR were used. RESULTS: Thirty-two of 112 acute
episodes were caused by P carinii. Diff-Quik had the highest sensitivity
(84.8%) as compared to fungifluor stain (60.0%), DIFT (59.4%) and PCR
(65.6%). The specificity was 98.7% with Diff-Quik, 100% with fungifluor
stain, and 98.6% and 97.3% with DIFT and PCR, respectively. Accuracy was
high with every method (94.4% with Diff-Quik, 88.3% with fungifluor
stain, 86.7% with DIFT and 87.6% with PCR). CONCLUSION: Diff-Quik is a
good diagnostic tool in the diagnosis of PCP. The combination of
Diff-Quik and fungifluor stain is recommended because of its
cost-effectiveness and because of its rapid diagnosis of severe PCP. PCR
and DIFT should be used only on patients judged clinically to have PCP
with discrepant results in Diff-Quik and fungifluor stain in BALF
samples.
DE AIDS-Related Opportunistic Infections/*DIAGNOSIS *Bronchoalveolar
Lavage Comparative Study Fluorescent Antibody Technique, Direct Human
Pneumonia, Pneumocystis carinii/*DIAGNOSIS Polymerase Chain Reaction
Sensitivity and Specificity Staining JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).