PNEUMOCYSTIS CARINII PNEUMONIA ASSOCIATED WITH HYPOGAMMAGLOBULINAEMIA RESPONDING TO PENTAMIDINE

Treatment of pneumocystis carinii pneumonia in children

Eighteen children with pneumocystis carinii pneumonia diagnosed over a period of 16 years at a children's hospital are reviewed. All had an underlying disease, either congenital immunodeficiency or a malignancy. 15 patients were treated, 10 with pentamidine isethionate alone, 2 with both pentamidine and co-trimoxazole, and 3 with co-trimoxazole alone. 12 of the treated group recovered and the 3 untreated patients died. The 3 deaths after treatment occurred in children receiving pentamidine alone, and in whom secondary factors contributed. The side effects of treatment with pentamidine were high, and included local reactions, hypoglycaemia, and uraemia. However, our results confirm that pentamidine is an effective treatment for pneumocystis carinii pneumonia in childhood. Co-trimoxazole may be an effective and relatively nontoxic alternative treatment.

Pneumocystis carinii pneumonia and reticuloses

Three cases of Pneumocystis carinii pneumonia occurring in the course of diseases of the lymphoreticular system are described. One case was diagnosed in life and unsuccessfully treated with pentamidine isethionate. Incidence of the pneumonia is associated with a depressed immune response and may be more frequent than is usually realized in patients with reticuloses who are receiving corticosteroid and cytotoxic drugs.

A prospective study of staphylococcal infection and its prevention among infants and mothers after childbirth in hospital and at home

Staphylococcal colonization and infection were studied prospectively in infants, mothers and households after childbirth at home and in hospital. Infants were treated prophylactically with frequent applications of ‘Ster-zac’ hexachlorophane dusting powder. Some were treated in addition with ‘Naseptin’ nasal disinfectant cream.

The incidence of staphylococcal sepsis in infants was much less than before the adoption of hexachlorophane prophylaxis. The sepsis rate was further reduced when ‘Naseptin’ was used in addition to hexachlorophane. Of the two prophylactic agents, hexachlorophane was the more convenient and probably the more effective. ‘Naseptin’ was difficult to employ correctly and unsuitable for routine use.

The treatment of infants with disinfectants reduced nasal carriage markedly in infants and to a smaller extent in mothers. Both agents contributed to the reductions which persisted for some weeks after treatment ceased.

Breast abscesses were almost entirely confined to mothers of infants who became nasal carriers by the second week of life.

Staphylococcal colonization of infant's skin was greater when they wore impervious garments, probably because skin moisture increased.