Document 0029
 DOCN  M95A0029
 TI    [Pneumocystis carinii pneumonia in infants with vertically acquired HIV
       infection in Switzerland]
 DT    9510
 AU    Berger C; Albisetti M; Fanconi S; Rudin C; Cheseaux JJ; Micallef J; Kind
       C; Nadal D; Universitats-Kinderklinik Zurich.
 SO    Schweiz Med Wochenschr. 1995 Jun 10;125(23):1162-7. Unique Identifier :
       AIDSLINE MED/95320548
 AB    OBJECTIVE: Review of incidence, clinical picture, therapy, and outcome
       of Pneumocystis carinii pneumonia (PCP) in infants with
       vertically-acquired HIV infection in Switzerland. METHODS: Inquiry among
       members of the Swiss Pediatrics AIDS Group, review of the data base of
       the Swiss Neonatal HIV Study and retrospective analysis of the charts
       from infants with PCP. RESULTS: Since 1986 PCP has been diagnosed in 10
       out of 107 infants with vertically-acquired HIV infection. PCP occurred
       in 7 infants at the age of 3-6 months and in 3 at the age of 9-11
       months. 4 infants showed symptoms related to HIV infection before
       developing PCP. Before the development of PCP, infection with HIV had
       been ascertained in 6 infants. In 2 the diagnosis was still unclear and
       in the 2 remaining the risk of HIV infection was not known. None of the
       infants was on primary prophylaxis against PCP. Signs and symptoms of
       PCP included cough and tachypnea (100%) as well as high fever up to 40
       degrees C (90%). Transcutaneous oxygen saturation was 70-95%. Chest
       X-rays revealed interstitial infiltrates in 6 infants, localized
       infiltrates in 2 and interstitial as well as localized infiltrates in 2.
       The CD4+ cell count was, with one exception, < 1500/microliters, i.e.
       below the normal value for age. Side effects of high dose cotrimoxazole
       were noted in 6 patients. 5 infants required intubation and mechanical
       ventilation. 4 infants died due to PCP, including 3 of those who
       required intubation and mechanical ventilation. CONCLUSIONS: PCP in
       infants with vertically-acquired HIV infection preferentially occurs at
       the age of 3 to 6 months and is often lethal, especially in patients
       requiring intubation. Evaluation for HIV infection should be done as
       early as possible in order to introduce primary PCP prophylaxis in
       infants at risk for this opportunistic infection.
 DE    AIDS-Related Opportunistic Infections/COMPLICATIONS  Combined Modality
       Therapy  Disease Transmission, Vertical  English Abstract  Female  Human
       HIV Infections/DIAGNOSIS/*TRANSMISSION  Infant  Intensive Care  Male
       Pneumocystis carinii Infections/*COMPLICATIONS/PREVENTION &
       CONTROL/THERAPY  Retrospective Studies  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).