Pneumocystis carinii pneumonia. Diagnosis by examination of pulmonary secretions
W. K. Lau, L. S. Young and J. S. Remington
To determine if examination of respiratory secretions is useful in
diagnosing Pneumocystis carinii pneumonia, smear preparations of
expectorated sputum, tracheal aspirates, and transtracheal aspirates
stained by the Gomori methenamine silver nitrate method were examined.
Pneumocysts were observed more frequently in material obtained by
transtracheal aspiration than in secretions obtained by the other methods.
Transtracheal aspiration yielded material containing pneumocysts in 8 (13%)
of 60 patients; each had pulmonary infiltrates and clinical courses
consistent with P carinii pneumonia. Of 330 smear preparations examined
from expectorated sputum, three patients had pneumocysts in their sputum
and one had organisms in both transtracheal aspiration and expectorated
sputum; all three had pneumonia. This study provides evidence that
transtracheal aspiration is a useful initial step in the approach to the
diagnosis of P carinii pneumonia.
