AIDS`li ve diğer immun suprese hastalarda pneumocystis carinii pnömonisinin tanısında çeşitli yöntemlerin karşılaştırılması

Abstract

- 68 5. P.carinii was detected in 11 of 110 IS and 14 of 111 BAL specimens. In patients from whom both IS and BAL fluids were examined, 4 specimens were found to be positive in 25 IS and 6 in 25 BAL fluids. Although the positivity rate in IS and BAL fluids was not found significant (p>0.50), the parasite detec tion was easier and parasites were more abundant in BAL fluids. 6. When various staining techniques were compared for the detection of P.carinii, IFA proved to be superior than others. IFA gave positive results in 25 of 221 specimens and there was not any specimens that found positive by any one of other techiques if the IFA was negative. The six positivity in the group without HIV infection were detected only by IFA. P.carinii was detected in the same 13 specimens with methanamine silver nitrate and toluidine blue 0, in 10 specimens with RAL 555. In view of these results, IFA technique was found significantly more sensitive than RAL 555 (p <0.01). The differences between the results of RAL 555, methanamine silver nitrate and toluidine blue 0 techniques were, insignificant (p^>0.50). 7. The avarage total time from the beginning to the end of examina tion was found quite different for RAL 555 and IFA. While the time required to prepare the smears was equal for all techniques the staining period was shortest in RAL 555 and microscopic, examination period was shortest in IFA. 8. From our findings it was cocluded that to use two methods simultaneously, one a quick method such as RAL 555 that stains trophozoites and sporozoites in 1 to 2 minutes and the other a reliable method such as IFA that gives more positive results than others, should be recommended for detection of P.carinii.- 69 - 9. Although the presence of few parasites but abundant cells and bacteria creates difficulty in diagnosis and gives some false negative results, IS specimens should be examined first especially in HIV positive patients because of ease to obtain it. If IS specimen gives negative result, BAL specimen should be collected and examined. P.carinii is observed less is number in the specimens obtained from HIV negative immunosuppressed patients. In these patients although IFA method may detect the parasite in some IS specimens, BAL fluid should be preferred.- 68 5. P.carinii was detected in 11 of 110 IS and 14 of 111 BAL specimens. In patients from whom both IS and BAL fluids were examined, 4 specimens were found to be positive in 25 IS and 6 in 25 BAL fluids. Although the positivity rate in IS and BAL fluids was not found significant (p>0.50), the parasite detec tion was easier and parasites were more abundant in BAL fluids. 6. When various staining techniques were compared for the detection of P.carinii, IFA proved to be superior than others. IFA gave positive results in 25 of 221 specimens and there was not any specimens that found positive by any one of other techiques if the IFA was negative. The six positivity in the group without HIV infection were detected only by IFA. P.carinii was detected in the same 13 specimens with methanamine silver nitrate and toluidine blue 0, in 10 specimens with RAL 555. In view of these results, IFA technique was found significantly more sensitive than RAL 555 (p <0.01). The differences between the results of RAL 555, methanamine silver nitrate and toluidine blue 0 techniques were, insignificant (p^>0.50). 7. The avarage total time from the beginning to the end of examina tion was found quite different for RAL 555 and IFA. While the time required to prepare the smears was equal for all techniques the staining period was shortest in RAL 555 and microscopic, examination period was shortest in IFA. 8. From our findings it was cocluded that to use two methods simultaneously, one a quick method such as RAL 555 that stains trophozoites and sporozoites in 1 to 2 minutes and the other a reliable method such as IFA that gives more positive results than others, should be recommended for detection of P.carinii.

- 69 - 9. Although the presence of few parasites but abundant cells and bacteria creates difficulty in diagnosis and gives some false negative results, IS specimens should be examined first especially in HIV positive patients because of ease to obtain it. If IS specimen gives negative result, BAL specimen should be collected and examined. P.carinii is observed less is number in the specimens obtained from HIV negative immunosuppressed patients. In these patients although IFA method may detect the parasite in some IS specimens, BAL fluid should be preferred.- 68 5. P.carinii was detected in 11 of 110 IS and 14 of 111 BAL specimens. In patients from whom both IS and BAL fluids were examined, 4 specimens were found to be positive in 25 IS and 6 in 25 BAL fluids. Although the positivity rate in IS and BAL fluids was not found significant (p>0.50), the parasite detec tion was easier and parasites were more abundant in BAL fluids. 6. When various staining techniques were compared for the detection of P.carinii, IFA proved to be superior than others. IFA gave positive results in 25 of 221 specimens and there was not any specimens that found positive by any one of other techiques if the IFA was negative. The six positivity in the group without HIV infection were detected only by IFA. P.carinii was detected in the same 13 specimens with methanamine silver nitrate and toluidine blue 0, in 10 specimens with RAL 555. In view of these results, IFA technique was found significantly more sensitive than RAL 555 (p <0.01). The differences between the results of RAL 555, methanamine silver nitrate and toluidine blue 0 techniques were, insignificant (p^>0.50). 7. The avarage total time from the beginning to the end of examina tion was found quite different for RAL 555 and IFA. While the time required to prepare the smears was equal for all techniques the staining period was shortest in RAL 555 and microscopic, examination period was shortest in IFA. 8. From our findings it was cocluded that to use two methods simultaneously, one a quick method such as RAL 555 that stains trophozoites and sporozoites in 1 to 2 minutes and the other a reliable method such as IFA that gives more positive results than others, should be recommended for detection of P.carinii.- 69 - 9. Although the presence of few parasites but abundant cells and bacteria creates difficulty in diagnosis and gives some false negative results, IS specimens should be examined first especially in HIV positive patients because of ease to obtain it. If IS specimen gives negative result, BAL specimen should be collected and examined. P.carinii is observed less is number in the specimens obtained from HIV negative immunosuppressed patients. In these patients although IFA method may detect the parasite in some IS specimens, BAL fluid should be preferred.