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  • Title: Atypical Pneumocystis carinii pneumonia: the potential hazards of empiric treatment.
    Author: Peters JW, Sattler FR.
    Journal: South Med J; 1983 Jun; 76(6):800-3. PubMed ID: 6602384.
    Abstract:
    Pneumocystis carinii pneumonia occurred in two patients with unusual clinical findings. In one case, P carinii infection was diagnosed for the first time in a patient with Crohn's disease. Due to the lack of typical features in both cases an empiric trial of antimicrobial therapy could have delayed diagnosis and initiation of specific treatment for P carinii. Contrariwise, without histologic confirmation, specific therapy for P carinii pneumonia might have been mistakenly discontinued in the second patient. Empiric therapy with trimethoprim-sulfamethoxazole may cause rapid disappearance of P carinii cysts from pulmonary tissues and cause subsequent biopsies to be falsely negative in patients who fail to respond to treatment.
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