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Volume 20, Number 9—September 2014
CME ACTIVITY - Research

Pneumocystis jirovecii Pneumonia in Patients with or without AIDS, France

Antoine Roux, Emmanuel Canet, Sandrine Valade, Florence Gangneux-Robert, Samia Hamane, Ariane Lafabrie, Daniéle Maubon, Anne Debourgogne, Soléne Le Gal, Fréderic Dalle, Marion Leterrier, Dominique Toubas, Christelle Pomares, Anne Pauline Bellanger, Julie Bonhomme, Antoine Berry, Isabelle Durand-Joly, Denis Magne, Denis Pons, Christophe Hennequin, Eric Maury, Patricia Roux1, and Élie AzoulayComments to Author 
Author affiliations: Centre Medico-Chirurgical FOCH, Suresnes, France (A. Roux); Hôpital Saint-Louis, Paris, France (E. Canet, S. Valade, S. Hamane, A. Lafabrie, É. Azoulay); Centre Hospitalier Universitaire (CHU) de Rennes, Rennes, France (F. Gangneux-Robert ); CHU de Grenoble, Grenoble, France (D. Maubon); CHU de Nancy, Nancy, France (A. Debourgogne); Centre Hospitalier Régional et Universitaire de Brest, Brest, France (S. Le Gal); CHU de Dijon, Dijon, France (F. Dalle); CHU de Nantes, Nantes, France (M. Leterrier); CHU de Reims, Reims, France (D. Toubas); Hôpital de l’Archet, Nice, France (C. Pomares); CHU Jean Minjoz, Besançon, France (A.P. Bellanger); CHU Côte de Nacre, Caen, France (J. Bonhomme); CHU de Toulouse, Toulouse, France (A. Berry); CHU de Lille, Lille, France (I. Durand-Joly); Hôpital Saint-Antoine, Paris (D. Magne, C. Hennequin, P. Roux, E. Maury); CHU Gabriel Montpied, Clermont-Ferrand, France (D. Pons)

Main Article

Table 1

Clinical characteristics of 544 patients with and without AIDS at diagnosis with PCP, France, January 1, 2007–December 31, 2010*

Characteristic AIDS patients, n = 223 Non-AIDS patients, n = 321 p value
Clinical features
Prophylaxis prescribed† 3 (1) 12 (4) 0.06
Temperature >38°C 165 (74) 263 (82) 0.05
Days from constitutional symptom onset to diagnosis, median (IQR) 30 (14–60) 7 (2–15) <0.0001
Shock
 5 (2.2)
 23 (7)
 0.01
Respiratory symptoms
Cough 170 (76.2) 173 (54) <0.0001
Dyspnea 176 (79) 234 (73) 0.10
Days from respiratory symptom onset to diagnosis, median (IQR)
 21 (7–30)
 5 (1–15)
 <0.0001
Laboratory test results
SpO2, median (IQR) 95 (90–97) 91 (86–96) 0.003
Lymphocyte count, cells/mm3, median (IQR) 802 (499–1,200) 500 (278–880) 0.0004
CD4+ T-cell count, cells/mm3, median (IQR) 167 (89–342) 32 (12–75) <0.0001
C-reactive protein
 48 (17–128)
 120 (59–210)
 <0.0001
Radiologic findings
Chest radiograph results typical for PCP 183 (82) 247 (77) 0.23
Chest radiograph results atypical for PCP‡ 31 (14) 48 (15) 0.66
Pneumothorax 7 (3.1) 7 (2.2) 0.50
Chest radiograph results unremarkable 9 (4) 26 (8) 0.34
Atypical computed tomography scan pattern§ 15 (14) 22 (14) 0.47

*Values are no. (%) patients except as indicated. Data were missing for CD4+ T-cell count (372 patients), C-reactive protein (274 patients), and CT scan pattern (265 patients). PCP, Pneumocystis jirovecii pneumonia; IQR, interquartile range.
†Adherence to prescribed prophylaxis was unknown. Among already known HIV+ patients without prophylaxis and with available CD4+ T cell count (n = 74), median CD4+ T cell count was 33 cells/mm3 (range 12–85).
‡Defined as focal interstitial or alveolar consolidation.
§Defined as subpleural nodules, focal condensation, cavitation, or marked pleural effusion.

Main Article

1Deceased.

Page created: August 14, 2014
Page updated: August 14, 2014
Page reviewed: August 14, 2014
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