Clinical Study Of 31 Cases Of Pneumocystis Jiroveci Pneumonia

Purpose:Improve the clinician’s understanding of Pneumocystis pneumonia,familiarize with its epidemiology,,and focus on the characteristics of HIV-infected and non-HIV-infected PCP patients,and analyze the risk factors for PCP death.Method:From December 2012 to October 2017,Jiangxi Provincial People’s Hospital and Nanchang University First Affiliated Hospital diagnosed patients with PCP,including31 patients.The PCP was divided into HIV infection group and non-HIV infection group.The differences in clinical manifestations,imaging features,and laboratory tests between the two groups were compared.According to the survival status of patients,the patients were divided into death group and survival group,and the two groups were analyzed.PCP death risk factors.ResultsA total of 31 patients with PCP were included during the study,7 were associated with HIV infection,24 were non-HIV infected patients,including 13kidney transplants,6 simple nephrotic syndromes,3 rheumatic diseases,and 1esophageal cancer.1 nephrotic syndrome complicated with systemic lupus erythematosus.95.8%of non-HIV infected patients were treated with immunosuppressive agents during the onset.Seven HIV-infected individuals were found due to the first diagnosis of PCP-related symptoms.1.1.The most common clinical manifestation of PCP is fever(100%).Among non-HIV-infected patients,10 patients had cough(41.7%)and 18 patients had dyspnea or compulsion(75.0%).In patients with HIV infection,there were 6 cases of cough(85.7%),and 4 cases of breathing difficulty(57.1%).Of the 31 patients with PCP,12 had three symptoms,and 12 had two of them.7 patients only showed symptoms of fever.2.The average time interval from onset of admission to hospital admission for HIV-infected PCP patients was 15(4~60)days;the average time interval for onset of hospital visits for HIV-infected PCP patients was 5(1.5~7)days.3.Patients with HIV infection:CD4+T lymphocyte counts were(20±12)/mm~3,serum albumin levels were(27.97±3.21)g/dl,non-AIDS patients:CD4+T lymphocyte counts were(120±22)/mm~3,serum albumin was(32.70±7.13)g/dl.4.Among the 31 patients with confirmed PCP,3 were clearly diagnosed by histopathology,and 28 were confirmed by microbiological diagnosis of lower respiratory secretions(24 cases were diagnosed by Bronchoalveolar lavage fluid,and4 cases were confirmed by sputum diagnosis).5.Eight patients died of type I respiratory failure。6.Arterial blood oxygen pressure below 60 mmHg on admission is an important risk factor for death in patients with PCP.Conclusion1.Compared with HIV-infected patients,non-HIV-infected PCP patients are quite young,have a more acute onset,have less immunosuppressive status and have better nutritional status.2.The diagnosis of lower respiratory tract specimens of PCP is preferably bronchoalveolar lavage fluid.3.Arterial blood oxygen pressure below 60 mmHg on admission is an important risk factor for PCP death.