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Diagnosis of Pneumocystis carinii pneumonia by bronchoalveolar lavage in AIDS patients. Comparison of Diff-Quik, fungifluor stain, direct immunofluorescence test and polymerase chain reaction.
Acta Cytol. 1995 Nov-Dec; 39(6):1089-93.AC

Abstract

OBJECTIVE

To assess the sensitivity, specificity and accuracy of Diff-Quik, fungifluor stain, the direct immunofluorescence test (DIFT) and the polymerase chain reaction (PCR) in the diagnosis of Pneumocystis carinii pneumonia (PCP) in human immunodeficiency virus (HIV)-infected patients.

STUDY DESIGN

From December 1992 through November 1993, 112 bronchoalveolar lavage fluid (BALF) samples were obtained from 80 HIV-infected patients. BALF samples were processed for cytologic and microbiologic analysis and for PCR. Cytologic examination was carried out on Diff-Quik-stained cytocentrifuge preparations and with May-Grünwald-Giemsa staining and fungifluor staining. For diagnosis of PC infection, DIFT and PCR were used.

RESULTS

Thirty-two of 112 acute episodes were caused by P carinii. Diff-Quik had the highest sensitivity (84.8%) as compared to fungifluor stain (60.0%), DIFT (59.4%) and PCR (65.6%). The specificity was 98.7% with Diff-Quik, 100% with fungifluor stain, and 98.6% and 97.3% with DIFT and PCR, respectively. Accuracy was high with every method (94.4% with Diff-Quik, 88.3% with fungifluor stain, 86.7% with DIFT and 87.6% with PCR).

CONCLUSION

Diff-Quik is a good diagnostic tool in the diagnosis of PCP. The combination of Diff-Quik and fungifluor stain is recommended because of its cost-effectiveness and because of its rapid diagnosis of severe PCP. PCR and DIFT should be used only on patients judged clinically to have PCP with discrepant results in Diff-Quik and fungifluor stain in BALF samples.

Authors+Show Affiliations

IInd Medical Department, University of Vienna, Austria.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

7483981

Citation

Armbruster, C, et al. "Diagnosis of Pneumocystis Carinii Pneumonia By Bronchoalveolar Lavage in AIDS Patients. Comparison of Diff-Quik, Fungifluor Stain, Direct Immunofluorescence Test and Polymerase Chain Reaction." Acta Cytologica, vol. 39, no. 6, 1995, pp. 1089-93.
Armbruster C, Pokieser L, Hassl A. Diagnosis of Pneumocystis carinii pneumonia by bronchoalveolar lavage in AIDS patients. Comparison of Diff-Quik, fungifluor stain, direct immunofluorescence test and polymerase chain reaction. Acta Cytol. 1995;39(6):1089-93.
Armbruster, C., Pokieser, L., & Hassl, A. (1995). Diagnosis of Pneumocystis carinii pneumonia by bronchoalveolar lavage in AIDS patients. Comparison of Diff-Quik, fungifluor stain, direct immunofluorescence test and polymerase chain reaction. Acta Cytologica, 39(6), 1089-93.
Armbruster C, Pokieser L, Hassl A. Diagnosis of Pneumocystis Carinii Pneumonia By Bronchoalveolar Lavage in AIDS Patients. Comparison of Diff-Quik, Fungifluor Stain, Direct Immunofluorescence Test and Polymerase Chain Reaction. Acta Cytol. 1995 Nov-Dec;39(6):1089-93. PubMed PMID: 7483981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis of Pneumocystis carinii pneumonia by bronchoalveolar lavage in AIDS patients. Comparison of Diff-Quik, fungifluor stain, direct immunofluorescence test and polymerase chain reaction. AU - Armbruster,C, AU - Pokieser,L, AU - Hassl,A, PY - 1995/11/1/pubmed PY - 1995/11/1/medline PY - 1995/11/1/entrez SP - 1089 EP - 93 JF - Acta cytologica JO - Acta Cytol VL - 39 IS - 6 N2 - OBJECTIVE: To assess the sensitivity, specificity and accuracy of Diff-Quik, fungifluor stain, the direct immunofluorescence test (DIFT) and the polymerase chain reaction (PCR) in the diagnosis of Pneumocystis carinii pneumonia (PCP) in human immunodeficiency virus (HIV)-infected patients. STUDY DESIGN: From December 1992 through November 1993, 112 bronchoalveolar lavage fluid (BALF) samples were obtained from 80 HIV-infected patients. BALF samples were processed for cytologic and microbiologic analysis and for PCR. Cytologic examination was carried out on Diff-Quik-stained cytocentrifuge preparations and with May-Grünwald-Giemsa staining and fungifluor staining. For diagnosis of PC infection, DIFT and PCR were used. RESULTS: Thirty-two of 112 acute episodes were caused by P carinii. Diff-Quik had the highest sensitivity (84.8%) as compared to fungifluor stain (60.0%), DIFT (59.4%) and PCR (65.6%). The specificity was 98.7% with Diff-Quik, 100% with fungifluor stain, and 98.6% and 97.3% with DIFT and PCR, respectively. Accuracy was high with every method (94.4% with Diff-Quik, 88.3% with fungifluor stain, 86.7% with DIFT and 87.6% with PCR). CONCLUSION: Diff-Quik is a good diagnostic tool in the diagnosis of PCP. The combination of Diff-Quik and fungifluor stain is recommended because of its cost-effectiveness and because of its rapid diagnosis of severe PCP. PCR and DIFT should be used only on patients judged clinically to have PCP with discrepant results in Diff-Quik and fungifluor stain in BALF samples. SN - 0001-5547 UR - https://www.unboundmedicine.com/medline/citation/7483981/Diagnosis_of_Pneumocystis_carinii_pneumonia_by_bronchoalveolar_lavage_in_AIDS_patients__Comparison_of_Diff_Quik_fungifluor_stain_direct_immunofluorescence_test_and_polymerase_chain_reaction_ DB - PRIME DP - Unbound Medicine ER -