Many children who receive cancer chemotherapy are at increased risk for developing Pneumocystis carinii pneumonia (PCP). Despite knowledge of chemoprophylaxis, isolated incidents of PCP still occur. This article reviews the incidence, pathophysiology, clinical course, treatment and prevention of PCP. Case study vignettes exemplify variables contributing to non-compliance with prophylactic measures, as well as suggest areas for nursing intervention.
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References
1.
PereraD.R.Pneumocystis carinii pneumonia in a hospital for childrenJAMA214:6:1074–1078, November 9, 1970.
2.
SingerC.ArmstrongD.RosenP.Schottenfeld, Pneumocystis carinii pneumonia: A cluster of eleven cases. Ann. Intern. Med.82:6:772–777, June, 1975.
3.
RuebushT.An outbreak of Pneumocystis pneumonia in children with acute leukemiaAm. J. Dis. Child.132:2:143–148, February, 1978.
4.
ChusidM. J.HeyrmanB. A.An outbreak of Pneumocystis carinii pneumonia at a pediatric hospitalPediatrics62:6: 1031–1035, December, 1978.
5.
SimoneJ.V.HollandE.JohnsonW.Fatalities during remission of childhood leukemiaBlood39:5:759–770, June, 1972.
6.
HughesW.T.FeldmanS.SanyalS.Treatment of Pneumocystis carinii pneumonitis with trimethoprim-sulfamethoxazoleCan. Med. Assoc. J.112(Suppl. 13) 47–50, June, 1975.
7.
HughesW.T.Comparison of pentamidine isethionate and trimethoprim — sulfamethoxazole in the treatment of Pneumocystis carinii pneumoniaJ. Pediatr.92: 2:285–291, February, 1978.
8.
HarrisR.E.Prevention of Pneumocystis carinii pneumoniaAm. J. Dis. Child.134:1:35–38, January, 1980.
9.
MorganE.Decreased incidence of nonspecific interstitial pneumonitis in children with acute lymphocytic leukemia treated prophylactically with trimethoprim — sulfamethoxazoleJ. Pediatr.99:5: 807–809, November, 1981.
WolffL.J.BaehnerR. L.Delayed development of Pneumocystis carinii pneumonia following administration of short-term high dose trimethoprim-sulfamethoxazoleAm. J. Dis. Child.132:5:525–526, May, 1978.
14.
SiegalS. E.Pneumonia during therapy for childhood acute lymphoblastic leukemiaAn. J. Dis. Child.134:1:28–34, January, 1980.
15.
HughesW.T.Pneumocystis carinii pneumonitis in children with malignanciesJ. Pediatr.82:3:404–415, March, 1973.
16.
RuskinJ.RemingtonJ.S.The compromised host and infection. I. Pneumocystis carinii pneumoniaJAMA202:12: 1070–1074, December 18, 1967.
17.
BrazinskyJ.H.PhilliesJ.C.Pneumocystis pneumonia transmission between patients with lymphomaJAMA209:10:1527, September 8, 1969.
18.
WantanabeJ. M.ChinchinianH.WeitzC.McIlvanieS.Pneumocystis carinii pneumonia in a familyJAMA193:8:685–686, August 23, 1965.
19.
KuceraK.Pneumocystis as an anthropozoonosisAnn. Parasitol. Hum. Comp.42: 465, 1967.
20.
PifierL.Pneumocystis carinii: A diagnostic dilemmaPediatr. Infect. Dis.2:3: 177–183, May/June, 1983.
21.
CulbertS.PickeringL. Principles of Total Care. Physiologic Support. In SutowW.FernbachD.ViettiT. (Eds.), Clinical Pediatric Oncology, 3rd Edition. St. Louis: C.V. Mosby Co., 1984.
22.
JohnsonJ. F.RehderT.L.MooreG. F.Pneumocystis carinii pneumonia: Review with a case studyDrug Intell. Clin. Pharm.15:10:732–736, October, 1981.
23.
SenP.Superinfection: Another lookAm. J. Med.73:5:706–718, November, 1982.
24.
SahrfieldJ.McLaughlinJ.Open lung biopsy in diagnosis pulmonary infiltrates in immunosuppressed patientsAnn. Thorac. Surg.28:4:359–362, October, 1979.
25.
MasonW.H.SiegelS.E.TuckerB.Diagnostic open lung biopsy for diffuse pulmonary disease in immunocompromised pediatric patientsAm. J. Pediatr. Hematol. Oncol.4:4:355–359, Winter, 1982.
26.
KarayalcinG. Supportive care of the child with cancer. In LanzkowskyP. (Ed.), Pediatric Oncology: A Treatise for the Clinician.New York: McGraw-Hill Book Company, 1983.
27.
RubinR.H.SwartzM.N.Drug Therapy: Trimethoprim — sulfamethoxazoleN. Engl. J. Med.303:8:426–432, August, 1980.
28.
Physician's Desk Reference. New Jersey: Charles E. Baker, Jr., 1984.
29.
WilberR.B.Chemoprophylaxis for Pneumocystis carinii pneumonitis: Outcome of unstructured deliveryAm. J. Dis. Child.134:7:643–648, July, 1980.
30.
HughesW.T.Successful chemoprophylaxis for Pneumocystis carinii pneumonitisN. Engl. J. Med.297:26:1419–1426, December, 1977.
31.
WadeJ.C.A comparison of trimethoprim-sulfamethoxazole plus nystatin with gentamycin plus nystatin in the prevention of infections with acute leukemiaN. Engl. J. Med.304:18:1057, April, 1981.
32.
GoorinA.M.Prophylactic use of trimethoprim-sulfamethoxazole (T — S) in children with acute lymphocytic leukemia (Abstr.#754 Program Issue)Pediatr. Res.16:4:204A, April, 1982.
33.
DeWetB.HollingsheadJ.Medicine compliance in pediatric out — patientsS. Afr. Med. J.58:846–848, 1980.
34.
RuleyE. J.Compliance in young hypertensive patientsPediatr. Clin. North Am.25:5:175–182, February, 1978.
35.
LanskyS.B.SmithS.D.CairnsN.V.CairnsG.Jr.Psychological correlates of complianceAm. J. Fed. Hematol. Oncol.5:1:87–92, Spring, 1983.
