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Rapid noninvasive diagnosis of Pneumocystis carinii from induced liquefied sputum.
Ann Intern Med. 1988 Jul 01; 109(1):7-10.AIM

Abstract

Pneumocystis carinii organisms cluster in alveolar casts. A method for concentrating alveolar casts in sputum specimens might improve the diagnostic usefulness of sputum studies in possible cases of pulmonary infection with Pneumocystis carinii. The use of sputum induction to detect Pneumocystis carinii was studied in 40 consecutive patients with known or suspected human immunodeficiency virus infection having bronchoscopy for evaluation of pulmonary disease. Sputum produced by deep coughing induced by 3% saline via a jet nebulizer was liquefied with dithiothreitol, and cells were sedimented and stained. Liquefaction of mucus allowed concentration of alveolar casts where P. carinii cysts were readily identified. A total of 28 patients were found to have P. carinii, which was detected in concentrated sputum in 21 of 38 patients, unconcentrated sputum in 10 of 38 patients, and by bronchoscopy in 25 of 37 patients. Sensitivity of concentrated sputum compared with bronchoscopy was 78% (95% CI, 58 to 90), with a negative predictive value of 71% (95% CI, 47 to 87). Values for unconcentrated sputum were 43% (95% CI, 25 to 63) and 48% (95% CI, 30 to 67), respectively. Liquefaction of adequately induced sputum facilitates processing and interpretation and increases yield for P. carinii, eliminating the need for invasive procedures in most patients.

Authors+Show Affiliations

Brooklyn Veterans Administration Medical Center, New York.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

2454045

Citation

Zaman, M K., et al. "Rapid Noninvasive Diagnosis of Pneumocystis Carinii From Induced Liquefied Sputum." Annals of Internal Medicine, vol. 109, no. 1, 1988, pp. 7-10.
Zaman MK, Wooten OJ, Suprahmanya B, et al. Rapid noninvasive diagnosis of Pneumocystis carinii from induced liquefied sputum. Ann Intern Med. 1988;109(1):7-10.
Zaman, M. K., Wooten, O. J., Suprahmanya, B., Ankobiah, W., Finch, P. J., & Kamholz, S. L. (1988). Rapid noninvasive diagnosis of Pneumocystis carinii from induced liquefied sputum. Annals of Internal Medicine, 109(1), 7-10.
Zaman MK, et al. Rapid Noninvasive Diagnosis of Pneumocystis Carinii From Induced Liquefied Sputum. Ann Intern Med. 1988 Jul 1;109(1):7-10. PubMed PMID: 2454045.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid noninvasive diagnosis of Pneumocystis carinii from induced liquefied sputum. AU - Zaman,M K, AU - Wooten,O J, AU - Suprahmanya,B, AU - Ankobiah,W, AU - Finch,P J, AU - Kamholz,S L, PY - 1988/7/1/pubmed PY - 1988/7/1/medline PY - 1988/7/1/entrez SP - 7 EP - 10 JF - Annals of internal medicine JO - Ann Intern Med VL - 109 IS - 1 N2 - Pneumocystis carinii organisms cluster in alveolar casts. A method for concentrating alveolar casts in sputum specimens might improve the diagnostic usefulness of sputum studies in possible cases of pulmonary infection with Pneumocystis carinii. The use of sputum induction to detect Pneumocystis carinii was studied in 40 consecutive patients with known or suspected human immunodeficiency virus infection having bronchoscopy for evaluation of pulmonary disease. Sputum produced by deep coughing induced by 3% saline via a jet nebulizer was liquefied with dithiothreitol, and cells were sedimented and stained. Liquefaction of mucus allowed concentration of alveolar casts where P. carinii cysts were readily identified. A total of 28 patients were found to have P. carinii, which was detected in concentrated sputum in 21 of 38 patients, unconcentrated sputum in 10 of 38 patients, and by bronchoscopy in 25 of 37 patients. Sensitivity of concentrated sputum compared with bronchoscopy was 78% (95% CI, 58 to 90), with a negative predictive value of 71% (95% CI, 47 to 87). Values for unconcentrated sputum were 43% (95% CI, 25 to 63) and 48% (95% CI, 30 to 67), respectively. Liquefaction of adequately induced sputum facilitates processing and interpretation and increases yield for P. carinii, eliminating the need for invasive procedures in most patients. SN - 0003-4819 UR - https://www.unboundmedicine.com/medline/citation/2454045/Rapid_noninvasive_diagnosis_of_Pneumocystis_carinii_from_induced_liquefied_sputum_ DB - PRIME DP - Unbound Medicine ER -