Sha B, Benson CA, Deutsch T, Pottage JC, Murphy R, Noskin G, Kessler H; International Conference on AIDS.
Int Conf AIDS. 1991 Jun 16-21; 7: 285 (abstract no. M.B.2412).
Rush Medical College
OBJECTIVE: To characterize the clinical and laboratory features, response to therapy, and outcome of Pneumocystis carinii (PC) choroiditis (PCC) in patients (pts) with AIDS. METHODS: A retrospective chart review with longitudinal follow-up of all cases of PCC diagnosed from 1/89 to 12/90 from 2 tertiary care Chicago hospitals. RESULTS: Eight patients were diagnosed with PCC (7 men, 1 woman). Mean age was 36 yrs. Seven of 8 had previous PC pneumonia (PCP) and received aerosolized pentamidine (AP) prophylaxis for a mean of 12.6 mos. prior to PCC. One pt had no PCP history and had received no PCP prophylaxis. All 8 pts had visual symptoms at the time of PCC diagnosis; 3 had concurrent CMV retinitis, 1 had cryptococcal meningitis. Six of 8 pts had bilateral PCC. The mean CD4+ count for 6 pts near the time of PCC diagnosis was 18 cells/mm(3) (4-38). PCC was a preterminal diagnosis in 3 pts. Two of these had disseminated PC; 2 received no specific PC therapy and 1 received 21 days of intravenous (IV) pentamidine. PCC improved or resolved with therapy in the surviving 5 pts. One pt with PCC and disseminated PC responded to 21 days of IV trimetrexate and 14 days of dapsone/trimethoprim (dap/TMP). Of the 4 with localized PCC, 1 responded to 14 days of IV pentamidine followed by 21 days of dap/TMP and 3 responded to 21 days of dap/TMP. All 5 then received PC prophylaxis with dap (2), dap/TMP (2), or AP (1). The 1 pt on AP relapsed with PCC at 15 mos. The remaining 4 were PCC-free after a mean of 14 mos (10-18). Median survival from PCC diagnosis by Kaplan-Meier was 44 wks (2-78 wks). CONCLUSIONS: PCC is a late manifestation of AIDS occurring in those not receiving systemic PCP prophylaxis. Ocular signs and symptoms may resolve with specific PC therapy. Similar to CMV retinitis, PCC can be a local manifestation of disseminated disease. Systemic prophylactic therapy may be required to prevent reactivation.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Chicago
- Chorioretinitis
- Choroiditis
- Dapsone
- Female
- Humans
- Male
- Pentamidine
- Pneumonia, Pneumocystis
- Trimethoprim
- diagnosis
- psychology
- therapy
Other ID:
UI: 102183332
From Meeting Abstracts