Extrapulmonary Pneumocystis carinii infection in an AIDS patient:a casereport
BACKGROUND: Extrapulmonary Pneumocystis carinii (EPC) infection is anuncommon condition, regardless of HIV status, and can occur as a complication of P carinii pneumonia(PCP). However, PCP is the most common severe opportunistic infection in patients with AIDS. Theincidence of EPC is variable, and in HIV-1-infected individuals it has been estimated to be0.06-2.5%. CASE: A case of generalized lymphadenopathy was referred to us for fine needle aspirationcytology (FNAC). The patient was a 9-year-old boy who had a toxic facies and manifested multipleskin lesions all over the body. Fever was present during the examination. HIV status was confirmedfrom the history and test report. FNAC was done from a cervical lymph node and smears stained withhematoxylin-eosin and with Giemsa and Papanicolaou stain. The presence of P carinii was suspected inGiemsa- and hematoxylin-eosin-stained smears, and silver methenamine stain was used to confirm thediagnosis. Fungal spores were seen as small, spherical cysts of variable sizes, more or less thesize of erythrocytes. The diagnosis was thus established as EPC infection. CONCLUSION: Lymph nodeinvolvement is the most common site of pneumocystosis in AIDS patients. Fine needle aspirationdiagnosis of EPC infection is a possibility in such cases with lymphadenopathy and must be includedin the differential diagnosis of lymph node swellings in AIDS.
Anuradha　Sinha,A
Ganga Laboratory, Ulubari, Guwahati, India. anuradhanone@hotmail.com
Acquired Immunodeficiency Syndrome　 erucylphosphocholine　 DiagnosticInfection as complication of medical care
