Diagnóstico de pneumocistose pulmonar a microscopia a fresco
| Autor: | Enrique Bellegarde, Sylvia Cattáneo, A. J. Bava |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Pathology
medicine.medical_specialty lcsh:Arctic medicine. Tropical medicine lcsh:RC955-962 Pulmonary pneumocystosis Microscopy Pneumocystosis medicine Humans Direct fluorescent antibody AIDS-Related Opportunistic Infections Pneumocystis business.industry Pneumonia Pneumocystis Direct microscopy Sputum General Medicine respiratory system medicine.disease respiratory tract diseases PCP Pneumonia Infectious Diseases Pneumocystis carinii Fluorescent Antibody Technique Direct Wet mount Diagnosis of PCP and wet mount microscopy business Bronchoalveolar Lavage Fluid |
| Zdroj: | Revista do Instituto de Medicina Tropical de São Paulo, Vol 44, Iss 5, Pp 279-282 (2002) Revista do Instituto de Medicina Tropical de São Paulo; Vol. 44 No. 5 (2002); 279-282 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 44 Núm. 5 (2002); 279-282 Revista do Instituto de Medicina Tropical de São Paulo; v. 44 n. 5 (2002); 279-282 Revista do Instituto de Medicina Tropical de São Paulo Instituto de Medicina Tropical (IMT) instacron:IMT |
| ISSN: | 0036-4665 1678-9946 |
| DOI: | 10.1590/s0036-46652002000500009 |
| Popis: | We have compared the searching of the presence of "honeycomb" structures by direct microscopy on wet mount preparations with the direct immunofluorescence (DIF) for the diagnosis of Pneumocystis carinii pneumonia (PCP) in 115 bronchoalveolar (BAL) fluids. The samples belonged to 115 AIDS patients; 87 with presumptive diagnosis of PCP and 28 with presumptive diagnosis other than PCP. The obtained results were coincident in 114 out of 115 studied samples (27 were positive and 87 negative) with both techniques. A higher percentage of positive results (32.18%) among patients with presumptive diagnosis of PCP with respect to those with presumptive diagnosis other than PCP (3.57%) was observed. One BAL fluid was positive only with DIF, showed scarce and isolated P. carinii elements and absence of typical "honeycomb" structures. The searching for "honeycomb" structures by direct microscopy on wet mount preparations could be considered as a cheap and rapid alternative for diagnosis of PCP when other techniques are not available or as screening test for DIF. This method showed a sensitivity close to DIF when it was applied to BAL fluids of AIDS patients with poor clinical condition and it was performed by an experienced microscopist. Comparamos a presença de estruturas com aspecto de "favo de mel" através da microscopia a fresco e imunofluorescência direta (IFD) no diagnóstico de pneumocistose pulmonar (P. carinii) (PCP) em secreções do aparelho respiratório obtidas através do lavado bronco-alveolar (BAL) de 115 pacientes com AIDS. Oitenta e sete amostras pertenciam a pacientes com diagnóstico presuntivo de PCP e 28 a pacientes com outros diagnósticos diferentes de PCP. Os resultados obtidos foram coincidentes em 114 das 115 amostras pesquisadas (27 foram positivas e 87 negativas) com porcentagem mais elevada de resultados positivos entre os pacientes com diagnóstico presuntivo de PCP (32,18%) do que entre aqueles com outros diagnósticos presuntivos (3,57%). Um BAL (1,14%) foi positivo somente com a IFD que revelou poucas formas isoladas de P. carinii e ausência das estruturas típicas com aspecto de "favo de mel". A pesquisa de estruturas com aspecto de "favo de mel" através da microscopia a fresco poderia ser considerada como um método alternativo, econômico e rápido, para o diagnóstico de PCP, quando outras técnicas não estiverem disponíveis ou como prova de "screening" prévia antes do DIF. Esse método demonstrou sensibilidade semelhante a DIF aplicada em secreções do aparelho respiratório obtidas através do BAL em pacientes com AIDS com más condições clínicas quando executada por um microscopista experiente. |
| Databáze: | OpenAIRE |
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