Complications during clinical courses of Pneumocystis carinii pneumonia inpatients with acquired immunodeficiency syndrome

Objective To describe the incidence of complications before and during ther apy of Pneumocystis carinii pneumonia (PCP) in patients with acquired immun odeficiency syndrome (APDS). Methods A retrospective review of the patient's medical records. Patients A total of 29 patients with AIDS and PCP who were admitted to the AIDS Clinical Center, International Medical Center of Japan from July 1996 to November 1999. Results Adverse effects were found in 24 (88.9%) of 27 patients treated wit h trimethoprim/sulfamethoxazole (T/S), 6 (46.1%) of 13 treated with parente ral pentamidine, and 2 (20%) of 10 treated with inhaled pentamidine. Infect ious and/or non-infectious complications were found in 25 (86.2%) of 29 stu dy patients. Regarding infectious complications, 16 (55.2%) were found on a dmission and 10 cases (34.5%) with Infectious complications were identified during admission; including oral candidiasis (37.9% and 17.2%, respectivel y) and genital herpes (3.4% and 6.9%, respectively). Cytomegalovirus antige nemia was detected in 4 cases (13.8%) on admission and 12 cases (41.4%) dur ing admission. Non-infectious complications affected 11 cases (37.9%) on ad mission, and 6 cases (20.7%) during admission, the latter included heart fa ilure (10.3%) and pneumothorax (6.9%), PCP was successfully treated in all but one patient who suffered from repeated pneumothorax. Conclusion Treatment of PCP can be problematic and it Is important to be aw are of the high incidence of various complications that can occur during th e treatment of PCP.