My Patient is Spencer Jackson. He is 29 years old.For the past two weeks he has had a non-productive cough, a fever, and shortness of breath. He was an extremely active homosexual with multiple partners. The specimen taken was bronchoalveolar lavage with Pneumocystis carinii and Mycobacterium tuberculosis being the two possible isolates.
A chest radiograph revealed bilateral pulmonary infiltrates with both interstitial and alveolar markings. I have determined that the organism is Pneumocystis carinii for a few reasons. The first being the similarity of symptoms between the organism and the patient. They matched up almost identically.
Pneumocystis is very common among immunosuppressed individuals and with my patient being a homosexual, it would be an ideal assumption for him to be in the category for being a likely carrier of the AIDS virus. Another reason is its main location is in the lungs. With this particular organism, most of the symptoms and tests involved take place inside or close to the lungs. When one thinks of lungs, they mainly think of one disease: Pneumonia Pneumocystis carinii is a unicellular eukaryote.This organism is a protozoan and which isnt an easy substance to microscopically observe and come up with definite cell shape. It is also an anaerobe, which means that there needs to be oxygen present at all times.
Oxygen is required because the infection interferes with the exchange of gasses across the lung membranes. It is also required to maintain normal oxygen levels. Mycobacterium is also aerobic and they are non-endospore forming rods. They are prokaryotes. The name myco, meaning fungus-like, was derived from their occasional exhibition of filamentous growth. It grows in the lung as a slender, individual bacilli.
Because of its outer water-resistant layer, this bacteria is resistant to stresses such as drying and few antimicrobial drugs. Their structure is similar to that of gram-negative bacteria. Both of the possible organisms have expressed that they are widely found in AIDS patients. It occurs in approximately 80% of AIDS patients and is the major cause of death in that group. As I researched I found it almost impossible to read about one of these organisms and not read how related to AIDS it was.
To test for this particular organism one can perform a bronchoscopy or examine the sputum cytology. After performing a bronchoscopy, the results of the trachea and bronchii should contain normal secretions and no foreign bodies or obstructions. When looking at the results of the sputum, epithelial cells from the lining of the respiratory tract should be present. However, if any abnormal cells are located, this test would be a positive test and further actions should be considered.
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