[Retrospective analysis of relationship between radiological features and prognoses of pneumocystis pneumonia in non-AIDS immunocompromised patients].

Objective To elucidate the relationship between the radiological features and prognoses of pneumocystis pneumonia ( PCP ) in non-acquired immunodeficiency syndrome ( non-AIDS )immunocompromised patients.Methods Retrospective analyses were performed for the radiological features and prognoses of 36 non-AIDS immunocompromised PCP patients hospitalized at Peking University First Hospital from April 2006 to April 2010.There were 24 males and 12 females with an average age of (51.7 ±18.9) years.Results All patients underwent chest photographic examinations and chest computed tomography (CT) was performed on 29 of them.The overall case fatality rate (CFR) of 36 patients was 33.3 ％ (12/36).At the start of anti-PCP treatment,there were normal chest radiography ( n =7),bilateral diffuse infiltration ( n =21 ),bilateral diffuse consolidation ( n =8 ),aerothorax,mediastinal emphysema or pneumohypoderma ( n =6) and numbers of deceased patients ( n =0,8,5 and 5 respectively).The CFRs of the patients with normal chest radiography and aerothorax,mediastinal emphysema or pneumohypoderma were both statistically significant as compared with the overall rate ( P ＜ 0.05 ).At the start of anti-PCP treatment,there were bilateral diffuse ground glass opacities (GGO) (n =29 ),"mosaic sign" (n =19 ),air bronchogram (n =19),pulmonary consolidation ( n =17 ),bilateral pleural effusion ( n =7 ),thickened lobular septa (n =6),cystic lesions ( n =5 ),aerothorax,mediastinal emphysema or pneumohypoderma (n =4) and numbers of deceased patients (n =8,5,5,5,2,2,2 and 4 respectively).The CFRs of the patients with aerothorax, mediastinal emphysema or pneumohypoderma were statistically significant as compared with the overall rate (P ＜ 0.05).Conclusions The major radiological features of PCP in nonAIDS immunocompromised patients are bilateral diffuse infiltration.And bilateral diffuse GGO on chest CT scans are usually accompanied with " mosaic" sign,air bronchogram or pulmonary consolidation.The prognoses are excellent for the patients with normal chest radiograph and poor for those with aerothorax,mediastinal emphysema or pneumohypoderma. Key words: Pneumonia,pneumocystis; Acquired immunodeficiency syndrome; Radiological features; Prognosis