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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pneumocystis carinii pneumonia is a life-threatening complication of diseases and therapies associated with immunosuppression. Approximately 80 percent of patients with acquired immunodeficiency syndrome will develop pneumocystis pneumonia. Diagnosis is important, because effective therapy is available. In most cases, diagnosis can be made by sputum analysis. Bronchoalveolar lavage will yield a diagnosis in 85 to 90 percent of patients with pneumocystis pneumonia, and is used when sputum induction and analysis is unproductive, unavailable or negative. Transbronchial biopsy and, rarely, open lung biopsy will yield the etiology of pneumonia in the remaining patients. Pentamidine or trimethoprim-sulfamethoxazole is the treatment of choice. Toxicity often occurs, including hypoglycemia, nephrotoxicity, neutropenia and rash. Corticosteroids are helpful in moderate to severe disease. Mortality for the first episode of P. carinii pneumonia averages 20 percent. Prophylaxis effectively prevents and reduces the incidence of future episodes.
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PMID:Pneumocystis carinii: a deadly opportunist. 185 10

Pentamidine is effective in both the treatment and the prevention of Pneumocystis carinii pneumonia. The agent may be administered by slow intravenous infusion or aerosol, although intravenous therapy is associated with a wide range of adverse reactions, including nephrotoxicity, hypoglycemia and neutropenia. Toxic effects may occur in up to 25 percent of patients.
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PMID:Pentamidine for the prevention and treatment of P. carinii pneumonia. 266 25

This report reviews the use of trimethoprim-sulfamethoxazole (TMP-SMZ) in individuals with Pneumocystis carinii pneumonitis (PCP) and the acquired immunodeficiency syndrome (AIDS). Before AIDS, TMP-SMZ was at least as effective as pentamidine in pediatric and adult populations and was notably less toxic. In a study prospectively comparing TMP-SMZ with pentamidine in patients with AIDS, the toxicity associated with either therapy was very high, a problem suggesting a need for the development of additional types of therapy. There was no difference in the clinical responses to the different therapeutic regimens; the majority of patients showed some improvement. The rates of both major and minor toxic reactions were similar in the two groups, although the reactions differed qualitatively. In patients with AIDS rash was frequently associated with TMP-SMZ therapy and was almost never associated with pentamidine therapy. Neutropenia was common with both drugs. Pentamidine may produce hypoglycemia, which, though infrequent, may be life threatening. Neutropenia and rash are two adverse effects of TMP-SMZ therapy being described with great frequency in patients with AIDS. Mild neutropenia is common in patients with AIDS, even when therapy is not being administered. The high rate of toxic reactions limits the usefulness of TMP-SMZ for routine prophylaxis.
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PMID:Use of trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonitis in patients with acquired immunodeficiency syndrome. 355 57

We reviewed the charts of 38 patients with the acquired immunodeficiency syndrome who were treated for Pneumocystis carinii pneumonia. Only 5 of 37 patients started on trimethoprim-sulfamethoxazole were able to complete treatment; in 29 patients drug toxicity occurred and in 19 treatment was changed due to adverse reactions that included rash, fever, neutropenia, thrombocytopenia, and transaminase elevation. Pentamidine was given to 30 patients (1 as initial treatment); toxicity occurred in 13 but only 4 required a change in drug. Adverse reactions from pentamidine included fever, rash, neutropenia, transaminase elevation, azotemia, and hypoglycemia. Patients received trimethoprim-sulfamethoxazole a median of 9.5 days, and pentamidine, a median of 12.5 days. Toxicity from trimethoprim-sulfamethoxazole appeared earlier than toxicity associated with pentamidine (7.5 versus 9.5 days of treatment). In patients with the acquired immunodeficiency syndrome, trimethoprim-sulfamethoxazole has a higher incidence of adverse reactions than pentamidine (p less than 0.005).
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PMID:Adverse reactions to trimethoprim-sulfamethoxazole in patients with the acquired immunodeficiency syndrome. 623 Sep 76