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Michael N. Dohn, MD; Robert P. Baughman, MD; Ellen M. Vigdorth, PhD; Diana L. Frame

Arch Intern Med. 1992;152(12):2465-2470.

Abstract
Background.—
Second and subsequent episodes of acute Pneumocystis carinii pneumonia (PCP) are reported to have a worse prognosis than initial episodes in patients with the acquired immunodeficiency syndrome. We tested the hypothesis that survival rates of first, second, and subsequent episodes of acute PCP in patients with the acquired immunodeficiency syndrome are equal.

Methods.—
Analysis of the outcomes in prospective series of patients with the acquired immunodeficiency syndrome treated for acute PCP over 5 years.

Results.—
Survival rates of 222 PCP occurrences by episode number were: first, 86%; second, 84%; third, 88%; and fourth, 67%. Survival rates for the first, second, and third episodes were not significantly different. Second and third episodes had a larger proportion of patients with mild disease than initial episodes.

Conclusions.—
Survival rates for first, second, and third episodes of PCP in patients with the acquired immunodeficiency syndrome are not different. In contrast to earlier articles, treatment for second and third episodes of acute PCP may be as successful as in initial episodes.

(Arch Intern Med. 1992;152:2465-2470)

Footnotes
Accepted for publication June 13, 1992.

From the Department of Internal Medicine, University of Cincinnati (Ohio) Medical Center.

Presented in part at the American Thoracic Society meeting, Anaheim, Calif, May 15, 1991.

Reprint requests to 231 Bethesda Ave, Mail Location 564, Cincinnati, OH 45267-0564 (Dr Dohn).

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