PEDIATRICS Vol. 29 No. 5 May 1962, pp. 816-827
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INTERSTITIAL PNEUMONIA DUE TO PNEUMOCYSTIS CARINII, CYTOMEGALIC INCLUSION DISEASE AND HYPOGAMMAGLOBULINEMIA OCCURRING SIMULTANEOUSLY IN AN INFANT

A Case Report with Necropsy Findings

Robert I. Kramer M.D.1, Vincent C. Cirone M.D.1, and Halcuit Moore M.D.1

1 Departments of Pediatrics and Pathology (V.C.), Children's Medical Center, Parkland Memorial Hospital, and University of Texas Southwestern Medical School

A fatal case of Pneumocystis carinii pneumonia associated with generalized cytomegalic inclusion disease and hypogammaglobulinemia in a 6 month-old-infant has been presented. The differences between this case, typical of those that have been occurring in sporadic form, and the cases that occur in epidemic form have been discussed. It is the authors' belief that the hypogammaglobulinemia, directly related to the absence of plasma cells in the bone marrow and pulmonary parenchyma, was the predisposing factor in the pathogenesis of the Pneumocystis carinii pneumonia, and that the cytomegalic inclusion disease occurred because of the debilitated state of the patient brought about by the Pneumocystis carinii infection. Necropsy findings with electron-microscopic pictures of both the Pneumocystis carinii organism and and the cytomegalic inclusion disease virus have been presented. There is no specific therapy for Pneumocystis carinii pneumonia, although spontaneous recovery from the disease in its epidemic form may occur. In its sporadic form this disease has been universally fatal.