Chest
Original ResearchRespiratory InfectionsSerum Indicators for the Diagnosis of Pneumocystis Pneumonia
Section snippets
Patient Selection
We retrospectively evaluated data from 295 consecutive patients who underwent BAL for the diagnosis of PCP at Keio University Hospital (Tokyo, Japan) during the period from April 1998 until October 2005.
Data Collection
We reviewed the medical records of all the patients evaluated for demographic, BAL, and serum data. The following data were collected: age, sex, and underlying disease. The BAL data included the recovery of the fluid, which is the volume ratio of the saline solution recovered to the saline
Results
During the study period, PCP was diagnosed in 57 patients based on microscopic findings in BAL specimens. A total of 238 patients were PCP negative, 16 of whom were empirically treated with trimethoprim/sulfamethoxazole or pentamidine due to persistent suspicion about PCP or failure of the preceding treatment. Data from these 16 patients were excluded from the analysis because it was thought that they may have had PCP. All of the PCP-positive patients were treated initially with
Discussion
In the present study, we evaluated the roles of the serum markers LDH, β-D-glucan, KL-6, and CRP in the diagnosis of PCP. Although there have been several reports135691013 describing the levels of serum markers in PCP patients, the diagnostic significance of serum markers, including the newly identified β-D-glucan and KL-6, remains to be evaluated in a larger cohort of patients with a variety of underlying diseases.
The results of this study revealed that β-D-glucan is the most reliable
ACKNOWLEDGMENT
We thank Dr. Gregory A. Plotnikoff for review of the manuscript. We also thank Dr. Satoru Fukinbara for contributing to the statistical analysis.
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None of the authors have any conflicts of interest to disclose.