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Volume 20, Number 9—September 2014

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)

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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
5 (2.2)
23 (7)
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)
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)
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.

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