XXXX : a review of the epidemiology and clinical manifestations of a newly recognized infection.

@entity1 @entity286 @entity3617 @entity9463 @entity5131 @entity4502 @entity4440 @entity294 @entity2929 @entity810 @entity1215 @entity2028
During the 2-year period 1977 through 1979, 26 @entity1 with @entity4502 were seen at the Mayo Clinic and affiliated hospitals. The @entity1 ranged in age from 17 to 81 years with a median of 51 years. Twelve (46%) were immunologically compromised. Most of the other @entity1 had underlying chronic @entity286 @entity3617 . Hectic fever, cough, and @entity294 were common symptoms. Chest radiographs showed patchy perihilar infiltrates that often progressed to consolidation. Diagnosis was made by indirect fluorescent antibody testing in 15 @entity1 (58%), but in no case was the test diagnostic during the first week of illness. In seven @entity1 the diagnosis was established by positive direct flourescent antibody testing of lung tissue, in two cases by culture of lung tissue, and in one case each by direct fluorescent antibody positivity of sputum or bronchial washing. Of the 26 @entity1 , 3 (12%) required hemodialysis for @entity810 and 5 (19%) died. A favorable clinical response to therapy with @entity2929 was noted. The differential diagnosis of @entity4502 must include other @entity2028 , as well as @entity9463 , @entity4440 , @entity5131 . For critically ill @entity1 , open-lung biopsy may be necessary to provide a rapid diagnosis. Current evidence suggests that @entity2929 alone or in combination with @entity1215 is the treatment of choice. A 3-week course of therapy is recommended in order to prevent relapse.
