- Abstract-
E

The RoentgenologicaJ Study of Pneumocystic carinü Pneumonia
In Young Choi, M.D. , Suk Huh, M.D. , Yong Chul Lee, M.D. Han Suk Kim , M.D.
Department of Radiology, National Medicol Center,' Seoul, Korea
Keun Ch Sohn, M.D.
Pneumocystis carlnil pneumonia is caused by Preumocystls carini. It usually occurs in premature
or debilltated infants.
Recently sporadic cases of human dlsease in patients who have been on long term steroid therapy, cytotoxic drug therapy , immunoppressive drug were significantly Increased.
We recently experienced 35 cases of Pneumocystis carinii pneumonia in infants of an institution
for foreign adoption In three ep idemic period of Feb. 1979, Mar. 1980, and J an. 1981.
The clinical review of 35 cases was made.
Patients' age was between 1 to 4 months.
Twenty one cases (60%) occured In 2 month old infants.
Many patients were included in poor welght gain and development.
The common symptoms were tachypnea, cyanosis, restlessness. cough, diarrhea in order of frequency.
The roentgenological findings were classified into three groups: normal finding, pulmonary emphy-
sema only , and various forms of pneumonic infiltration.
The roentgenological findings were somewhat characteristic.
The most common flnding (24 cases) showed streaky and mottled densities which began in both hili
and were spreaded perlpherally.
The prominence between alveolar and Interstitial infiltration was almostly equal when patients were
admitted.
- 68 -

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1) ~ 3) 41 51 6!
Trimethoprim
Sulfamethoxazole (Bact rim, Septrin)
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9) 10) 11) 20
t;E 1979 2 . 1980
3 . 1981 1
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35 X t1( iiE
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1979 2 ( 1 ) 1980 3 (2) 1981 1
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u

Pneumocysti s carinii
8 X j%
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4
wrJ I
X jJE 3-"--4
5 IJ ?
.
T rimethoprim 20mg/ kg, S ulf amethoxa-
zole 1001 /kg 1 4 2

25 (60% )
7 (20%)
28 (80%) (Table 1.). 1 ~3
.
1M 4M Total 2M 3M
Male
Female
7
-%
6
15
1
.
t1(jJE H
. nasal flaring, I!t coryza,
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PO 0
.
14. 2% (5 ) 1

X 35
. (5
) (3 )
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(Fig. l. ) . a r- bronchogram .(Fig.
2)
l
F. 1. Admission roentgenogram showing biIateral streaky and granular densities in both medial lungs. Sparing the periphera1 1urs.
3 wr;
8 'Ii~i
X {f[I!ij |!
‘ P

f (Fig. 3). :fif
f (Fig. 4). ~.~~ .~ ij
F. 3. Admission roentgenogram showing streaky den­ sities in both media1 lung fields with homenous
increased desity in the right upper lung.


( Fig. 5)
nR O
Îf
(Table n .). x 3
.
F.2. Expired case: (Ieft) Admission roentgenograrn showÏI hazy and streaky densities in both medial ng fields. (right) Fonow up roentgenogram demonstrated extension of inf1ltration toward the periphery of lung. AÏI bronchogram is well
- 70 -
volved extensively both entire lung fies.
F. S. Adrnission roentgenogram showing hazy desnity in right upper lung and rnottled densities in both perilúlar regions. Ernphysematous change in both lower lungs. Both diaphragrns are flattened and depressed
Table 11. Findings on Chest P A Filrns
1. NorrnaI finding
2. Pneumonic infiltration
a. bilateral infiltration
3. Pulmonary emphyserna without pneumic in ftItration
- 71 -
N.
Ammich Inte r s titial plas ma cell pne­
umoma
Jivorec Inte r stitial
plasma cell pneumonia Pneumocystis carinii
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Chagas (1909) Pneumocys -
ti s carinii Iq f
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|
Saphrophyte
g {
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Pneumooystis carinii '*



1iJ‘
Jt;(
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(46.9%) , zlíF. ( 12.9%)
( 11.4%) Hodgkins (10.8%) A
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1:
Z
IF
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5 cases (1 4 .3%)
27 cases (77.1 %)
~~ 6 l Pneumocyst is carinii {
j l
$IJI 'J 1 IJfl { 1

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181 191
Gadju sel %
2 { 53 IJ
k
70% 1α 111
14) 21)
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fiI
i 1

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19 (9IJ Bt
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1 l :(911
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20)
X
{ 1 o-l r ] λ< -'ι - r
X Pneumocys ti s carinii 3 . exudative stage
lf R jj
Ú'J~ proteinaceous
exuda tion 8} pneumocystls
carinii t
, collopes stage
ßi1ïR
11í 0 Illli

1 j
l 11
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‘ 35
47%
l
. j{F. fj


.
(25- 100%)'~ 20
{R T rimetho -
prim sulfa methoxazole ’ ,'1
1 f 5%
151
}1
- - 72 - -


1] ‘ % j1m Pneumocystis carinii
j
lVf
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.
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7967.
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eumocystis Carinii 15 J Korea Ped
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