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An extremely elevated erythrosedimentation rate (ESR), defined as equal or higher than 100 mm/h, has been linked to serious underlying conditions, such as infections, connective tissue and oncologic disease.To analyze a group of patients in order to determine the underlying diagnosis and the characteristics associated with extremely elevated ESR in our environment.Cross-sectional study of adult patients, who presented with at least one ESR equal or higher than 100 mm/h at Hospital Italiano, in Buenos Aires (Buenos Aires, Argentina) between January 2002 and August 2014.During the previously stated period of time, we analyzed the results of 879 patients. All patients were over 18 years of age. The median for the ESR results was 111 mm/h (interquartile range 105-120). The most prevalent etiology of an elevated ESR was infectious (41.64%), followed by malignancies (21.62%) and autoimmune / inflammatory diseases (12.97%). The most frequent individual diagnosis found was pneumonia (11.49%), followed by undetermined causes (5.92%).When comparing inpatient versus outpatient populations, the most frequent cause was infectious in the former group, while malignancies were the most frequent diagnosis in the latter.

Respiratory infection caused by Pneumocystis jiroveci is a common opportunistic infection in patients with human immunodeficiency virus (HIV) with CD4 counts200 cells/mm(3). However, it has also been reported in patients with other causes of immunosuppression.To compare the characteristics, severity and mortality of respiratory infection by P. jiroveci in patients with and without HIV infection.Retrospective cohort follow-up of adult patients admitted to our hospital with infection by P. jiroveci since 2006 to 2013.We included 82 patients with respiratory infection by P. jiroveci of which 55% (45) were not infected with HIV. In this group, 68.8% (31) had diagnosis of cancer and 20% (9) received solid-organ transplant. 57.9% (26) were hospitalized in an intensive care unit. 42.2% (19) suffered multiple organ failure (MOF), 46.7% (21) required mechanical ventilation (MV) and 40.9% (18) inotropic drugs. Mortality was 33.3% (15). Statistically significant differences were observed between groups in age (p0.001), requirement of MV (p0.001) inotropic drugs (p 0.001) and MOF (p0.001). Mortality was higher in the HIV-positive group, reaching statistical significance (p 0.007).Pneumocystis pneumonia mortality was higher in patients without HIV, who suffered more complications and progression to respiratory failure with MOF.