carinii is an opportunistic infection found in patients with
Under favourable conditions the parasite can spread via the blood stream or lymphatic vessels and cause extrapulmonary dissemination.
There are cases of Pneumocystis carinii infection presenting as bilateral aural polyps, otitis media and mastoiditis in human immunodeficiency (HIV)-positive patient with no history of prior or concomitant Pneumocystis carinii infection.
Clinically, the patient may initially present with hearing loss and otalgia together with thickening of the tympanic membrane and the bordering skin of the ear canal.
Otorrhea, ear polyps, perforation of tympanic membrane, destruction of mastoidal bone, and participation of cranial nerves are observed.
Diagnosis is established histologically.
Due to the underlying immunological incompetence the infection can not be expected to limit itself.
To prevent severe complications as sequestrating mastoiditis, early diagnosis and specific surgical and medical treatment are necessary.
The treatment of the parasite is by trimethoprim-sulfamethoxazole combinations.
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