Pneumocystis carinii pneumonia in the acquired immune deficiency syndrome: response to inadvertent steroid therapy
MacFadden, D.K.; Edelson, J.D.; Rebuck, A.S.
Canadian Medical Association Journal 132(10): 1161-1163
1985
ISSN/ISBN: 0008-4409 PMID: 3873272 Document Number: 253430
A case of P. carinii pneumonia in an AIDS patient who denied homosexual activity is reported. A specimen from an open lung biopsy was initially interpreted as showing interstitial fibrosis. Treatment with prednisone 80 mg/day orally was given. Within 2 days the patient improved. The patient received a total of 5 days of steroid therapy before the final pathology was received, describing alveoli packed with P. carinii trophozoites and cysts. The patient then admitted repeated homosexual encounters. Steroid therapy was replaced by treatment with trimethoprim-sulphamethoxazole (20 to 100 mg/kg daily). The patient improved. It is suggested that corticosteroid therapy may prove useful as an adjunct to specific antimicrobial therapy. A case report. [The "inadvertant" (or, rather, inappropriate) therapy was given because the findings of an open-lung biopsy were initially interpreted as showing interstitial fibrosis, in the absence of any recognized risk factors (later admitted) for AIDS.].