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https://www.readbyqxmd.com/read/29668131/-severe-hypoxemic-respiratory-failure-caused-by-pneumocystis-jirovecii-in-a-late-kidney-transplant-recipient
#1
John Fredy Nieto-Ríos, Mónica Zuluaga-Quintero, Arbey Aristizábal-Alzate, Catalina Ocampo-Kohn, Lina María Serna-Higuita, Isabel Cristina Ramírez-Sánchez, Gustavo Adolfo Zuluaga-Valencia
Pneumonia caused by Pneumocystis jirovecii is an uncommon infection in kidney transplant patients that can have an acute and rapid progression to respiratory failure and death. The period of greatest risk occurs in the first six months after the transplant, and it relates to the high doses of immunosuppression drugs required by patients. However, it may occur late, associated with the suspension of prophylaxis with trimethoprim-sulfamethoxazole.We present two cases of renal transplant patients who had severe hypoxemic respiratory failure due to P...
March 15, 2018: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/29666966/point-of-care-lung-ultrasound-for-diagnosis-of-pneumocystis-jirovecii-pneumonia-notes-from-the-field
#2
Maria Teresa Giordani, Francesca Tamarozzi, Daniel Kaminstein, Enrico Brunetti, Tom Heller
BACKGROUND: Thoracic ultrasound is helpful to evaluate lung pathology in patients with acute dyspnea. Several studies have demonstrated the efficacy of point-of-care ultrasound in patients with extrapulmonary TB and HIV co-infection. This retrospective, open-label case-control study explores the role of lung ultrasound in the diagnosis of Pneumocystis jirovecii pneumonia (PJP) in HIV-positive patients. In particular, it highlights the potential role of specific sonographic features that may be unique to this population...
April 17, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29664819/risk-factors-for-pneumocystis-jirovecii-pneumonia-in-patients-with-rheumatoid-arthritis-and-a-prophylactic-indication-of-trimethoprim-sulfamethoxazole
#3
Kazutoshi Yukawa, Yasutsugu Nagamoto, Hirofumi Watanabe, Masamoto Funaki, Mitsuhiro Iwahashi, Jiro Yamana, Rie Sasaki, Seizo Yamana
BACKGROUND/OBJECTIVES: Immunosuppressant medications (ISPs) increase the occurrence of Pneumocystis jirovecii pneumonia (PCP) in rheumatoid arthritis (RA) patients. The prophylactic administration of trimethoprim/sulfamethoxazole (TMP/SMX) for PCP is effective but has serious adverse effects and so should be selectively used for patients at high risk. The aims of this study were to clarify the risk factors for PCP in RA patients and to establish the indications for administering TMP/SMX...
April 17, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/29663992/-systemic-review-the-accuracy-of-lactic-dehydrogenase-in-the-diagnosis-of-pneumocystis-pneumonia
#4
Chuntao Deng, Yimin Li, Yi Li
OBJECTIVE: To study the accuracy of lactic dehydrogenase (LDH) in the diagnosis of pneumocystis pneumonia (PCP). METHODS: The data of this systemic review was retrieved from the PubMed, China Biology Medicine disc, Wanfang, Weipu and China National Knowledge Infrastructure (CNKI) databases from establishment till to October 31st, 2017. Case-control studies about the diagnosis of PCP were enrolled. Enrolled studies were required that patients in case group ware PCP and patients in control group were lung diseases other than PCP...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29652202/effect-of-sulfasalazine-use-on-the-presence-of-pneumocystis-organisms-in-the-lung-among-patients-with-rheumatoid-arthritis-a-test-negative-design-case-control-study-with-pcr-tests
#5
Takahiro Nunokawa, Naoto Yokogawa, Kota Shimada, Shoji Sugii
OBJECTIVE: To evaluate the effect of sulfasalazine (SSZ) on the presence of Pneumocystis jirovecii (P. jirovecii) in the lungs of rheumatoid arthritis (RA) patients. METHODS: We retrospectively studied episodes of suspected P. jirovecii pneumonia (PJP) which were examined for P. jirovecii with polymerase chain reaction (PCR). We employed a test negative design case-control study; the cases were episodes of suspected PJP that were positive for PCR, and the controls were episodes of suspected PJP that were negative for PCR...
April 13, 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29629518/atypical-presentation-of-pneumocystis-jirovecii-infection-in-hiv-infected-patients-three-different-manifestations
#6
Bongyoung Kim, Jieun Kim, Seung Sam Paik, Hyunjoo Pai
Advances in the treatment and prevention of Pneumocystis jirovecii infection (PJI) in human immunodeficiency virus (HIV) patients decreased incidence and mortality dramatically, however, it may be associated with an increased frequency of unusual manifestation such as cystic formation, pneumothorax, focal infiltration, nodular formation, or extrapulmonary lesions. We report three cases of PJI with atypical manifestations. Each case demonstrates different clinical features: multiple nodular pulmonary lesion (32-year-old man with abnormal chest X-ray finding), subpleural mass-like lesion (43-year-old man with left visual loss and right pleuritic chest pain), and extrapulmonary mass-like lesions in the liver, lymph nodes, and small bowel (39-year-old man with cough, sputum, and dyspnea)...
April 9, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29622669/secular-trends-in-infection-related-mortality-after-kidney-transplantation
#7
Susanna Kinnunen, Pauli Karhapää, Auni Juutilainen, Patrik Finne, Ilkka Helanterä
BACKGROUND AND OBJECTIVES: Infections are the most common noncardiovascular causes of death after kidney transplantation. We analyzed the current infection-related mortality among kidney transplant recipients in a nationwide cohort in Finland. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Altogether, 3249 adult recipients of a first kidney transplant from 1990 to 2012 were included. Infectious causes of death were analyzed, and the mortality rates for infections were compared between two eras (1990-1999 and 2000-2012)...
April 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29620683/x-linked-severe-combined-immunodeficiency-and-hepatoblastoma-a-case-report-and-review-of-literature
#8
Sandra Diaz-Parra, Gema Lozano-Sanchez, Olga Escobosa-Sanchez, David Moreno-Perez, Antonio Morales-Martinez, Carolina Armengol-Niell, Tomás Acha-Garcia
Severe combined immunodeficiency is an inherited disease with profoundly defective T cells, B cells, and natural killer cells. X-linked severe combined immunodeficiency is the most common form. In this report, we describe a 4-month-old male infant who was admitted to our hospital with progressive breathlessness and abdominal mass. He was diagnosed with hepatoblastoma and presented a pneumocystis jirovecii pneumonia at the beginning of chemotherapy. Definitive diagnosis of X-linked severe combined immunodeficiency was established by DNA analysis of the interleukin 2 receptor gamma chain gene...
April 3, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29613974/fatal-p-jirovecii-and-cytomegalovirus-infections-in-an-infant-with-normal-trecs-count-pitfalls-of-newborn-screening-for-severe-combined-immunodeficiency
#9
Ana Mendez-Echevarria, Gonzalez-Granado Luis Ignacio, Luis M Allende, De Felipe Beatriz, Del Rosal Teresa, Calvo Cristina, Perez-Martinez Antonio, Ruiz Garcia Raquel, Neth Olaf
Newborn screening (NBS) for severe combined immunodeficiency (SCID) using T-cell receptor-excision circles (TRECs) allows prompt diagnosis and initiation of supportive and curative therapy thereby reducing morbidity and mortality. However, profound combined immunodeficiencies with normal numbers of non-functional T cells will go undetected. We present a patient with ORAI1 deficiency and normal TREC numbers observed after diagnosis at the age of 14 months who suffered from disseminated fatal cytomegalovirus and Pneumocystis jirovecii infection, demonstrating a potential pitfall of the current NBS program...
April 2, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29610164/-pneumocystis-jirovecii-pneumonia-during-sirolimus-therapy-for-kaposiform-hemangioendothelioma
#10
Thomas B Russell, Emily K Rinker, Claire S Dillingham, Laurence B Givner, Thomas W McLean
Sirolimus is an effective therapy for children with kaposiform hemangioendothelioma with or without the Kasabach-Merritt phenomenon. We report the case of a child with kaposiform hemangioendothelioma and the Kasabach-Merritt phenomenon who developed Pneumocystis carinii pneumonia (PCP) while on sirolimus and a prednisolone taper, after lack of adequate response to prednisolone, propranolol, and vincristine. He had a prompt positive clinical and laboratory response to sirolimus, but 4 weeks after starting it, at the age of 4 months, he developed PCP...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29607273/recurrent-pneumocystis-pneumonia-with-uncommon-radiographic-presentation
#11
Ayushi Dixit, Rayhan Shariff, Sherleen Gandham, Ravi Bhavsar, Jazila Mantis, Victoria Vapnyar
Pneumocystis carinii pneumonia (PCP) is a common opportunistic infection of the pulmonary parenchyma seen in the immunocompromised host. The clinical presentation and radiographic findings are varied, with the latter ranging from normal to bilateral ground-glass opacities with cyst formation. We present a case of a 46-year-old woman with a history of human immunodeficiency virus (HIV) with multiple treated prior episodes of PCP, who was found to have an impressive presentation on high-resolution chest computed tomography (HRCT)...
January 29, 2018: Curēus
https://www.readbyqxmd.com/read/29604970/central-nervous-system-infection-with-toxoplasma-gondii
#12
Christina M Marra
Central nervous system infection by Toxoplasma gondii, or Toxoplasma encephalitis, is the most common cause of brain mass lesions in human immunodeficiency virus (HIV)-infected patients. It usually presents as one or more brain abscesses, but it can also cause a diffuse encephalitis or ventriculitis. Individuals who are Toxoplasma immunoglobulin G-seropositive, who have peripheral blood CD4+ T-cell concentrations below 200/μL, are not on antiretroviral therapy, and are not taking trimethoprim-sulfamethoxazole to prevent Pneumocystis pneumonia, are at particular risk for Toxoplasma encephalitis...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29601494/the-burden-of-serious-fungal-infections-in-cameroon
#13
Christine E Mandengue, David W Denning
Fungal infections are frequent in Cameroon, and invasive fungal infections are sometimes detected, usually in HIV-infected patients. For these reasons, we have estimated the burden of fungal infections. Using published literature and population estimates for the at-risk group, we used deterministic modelling to derive national incidence and prevalence estimates for the most serious fungal diseases. HIV infection is common and an estimated 120,000 have CD4 counts <200 × 10⁶/mL and commonly present with opportunistic infection...
March 30, 2018: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29593714/bacterial-and-pneumocystis-infections-in-the-lungs-of-gene-knockout-rabbits-with-severe-combined-immunodeficiency
#14
Jun Song, Guoshun Wang, Mark J Hoenerhoff, Jinxue Ruan, Dongshan Yang, Jifeng Zhang, Jibing Yang, Patrick A Lester, Robert Sigler, Michael Bradley, Samantha Eckley, Kelsey Cornelius, Kong Chen, Jay K Kolls, Li Peng, Liang Ma, Yuqing Eugene Chen, Fei Sun, Jie Xu
Using the CRISPR/Cas9 gene-editing technology, we recently produced a number of rabbits with mutations in immune function genes, including FOXN1, PRKDC, RAG1, RAG2, and IL2RG. Seven founder knockout rabbits (F0) and three male IL2RG null (-/y) F1 animals demonstrated severe combined immunodeficiency (SCID), characterized by absence or pronounced hypoplasia of the thymus and splenic white pulp, and absence of immature and mature T and B-lymphocytes in peripheral blood. Complete blood count analysis showed severe leukopenia and lymphocytopenia accompanied by severe neutrophilia...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29577303/ct-findings-in-pneumocystis-carinii-pneumonia-in-five-dogs
#15
F Schiborra, C J Scudder, R M Littler, C R Lamb, J F McConnell, T W Maddox
Pneumocystis carinii pneumonia is a rare disease in dogs. It is primarily reported in cavalier King Charles spaniels and miniature dachshunds with suspected underlying immunodeficiency. This case series reports the findings in five dogs (four cavalier King Charles spaniels and one Bedlington terrier) with confirmed P. carinii pneumonia. Thoracic (CT) revealed ground glass opacity of the pulmonary parenchyma with a diffuse or multifocal distribution. The severity of this pattern was variable. Less consistent imaging findings included parenchymal bands, bronchial dilation and signs consistent with pulmonary hypertension...
March 25, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29575160/association-of-serious-infections-with-pemphigus-and-pemphigoid-analysis-of-the-nationwide-inpatient-sample
#16
Ziyou Ren, Shanthi Narla, Derek Y Hsu, Jonathan I Silverberg
BACKGROUND: Pemphigus and pemphigoid are blistering disorders associated with barrier disruption, immune dysregulation and use of immunosuppressing systemic therapy, which may predispose toward serious infections. OBJECTIVES: To determine whether pemphigus and pemphigoid are associated with increased likelihood of serious infections, and the impact of such infections on mortality and cost of care. METHODS: We analyzed data from the 2002-2012 National Inpatient Sample, including a representative 20% sample of all hospitalizations in the US (total n=72,108,077 adults)...
March 25, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29575136/diagnosis-of-pneumocystis-pneumonia-in-a-2-year-old-king-charles-cavalier-spaniel-using-the-polymerase-chain-reaction
#17
Ayeley A K Okine, Seth Chapman, Roger A Hostutler, Robert Livingston
A 2-year-old, female spayed, King Charles Cavalier Spaniel was presented for evaluation of dyspnea, inappetence, and lethargy. Thoracic radiographs revealed a moderate diffuse interstitial lung pattern affecting the perihilar and caudodorsal lung fields, and an echocardiogram revealed severe pulmonary hypertension. A bronchoalveolar lavage (BAL) was performed, and cytology revealed mixed inflammation with cysts and trophozoites consistent with Pneumocystis. Pneumocystis infection was later confirmed with PCR...
March 2018: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/29574652/extracorporeal-life-support-for-immune-reconstitution-inflammatory-syndrome-in-hiv-patients-with-pneumocystis-jirovecii-pneumonia
#18
Kollengode Ramanathan, Julian K Svasti, Graeme MacLaren
Patients with immunosuppression from human immunodeficiency virus (HIV) have been traditionally considered poor candidates for extracorporeal membrane oxygenation (ECMO) because of high in-hospital mortality and poor long-term survival. Highly active antiretroviral therapy (HAART) has improved survival rates in compliant HIV patients and reversible severe respiratory failure may warrant ECMO in this group. Immune reconstitution inflammatory syndrome (IRIS) involves excessive inflammatory response to a pathogen with paradoxical clinical deterioration following HAART initiation and may present as severe respiratory failure...
March 24, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29572070/escmid-study-group-for-infections-in-compromised-hosts-esgich-consensus-document-on-the-safety-of-targeted-and-biological-therapies-an-infectious-diseases-perspective-agents-targeting-lymphoid-or-myeloid-cells-surface-antigens-ii-cd22-cd30-cd33-cd38-cd40-slamf
#19
REVIEW
Lubos Drgona, Carlota Gudiol, Simone Lanini, Bernd Salzberger, Giuseppe Ippolito, Małgorzata Mikulska
BACKGROUND: The present review is part of the ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies. AIMS: To review, from an Infectious Diseases perspective, the safety profile of agents targeting CD22, CD30, CD33, CD38, CD40, SLAMF-7 and CCR4 and to suggest preventive recommendations. SOURCES: Computer-based MEDLINE searches with MeSH terms pertaining to each agent or therapeutic family...
March 20, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29563388/prevalence-of-opportunistic-infections-and-causes-of-death-among-hospitalized-hiv-infected-patients-in-sichuan-china
#20
Wenwen Pang, Pengcheng Shang, Qingfeng Li, Jiao Xu, Lei Bi, Jing Zhong, Xiaofang Pei
Opportunistic infections (OIs) are the most significant complication of human immunodeficiency virus (HIV) infection. The prevalence of OIs differs among various countries in part due to different climates and socio-economic conditions. We, therefore, carried out the retrospective study at the Public Health Clinical Center of Chengdu, Sichuan to comprehensively investigate the prevalence of OIs, predictors of OIs, and risk factors for in-hospital death among HIV-infected patients. Sichuan in West China is characterized by the largest population living with HIV/Acquired immunodeficiency syndrome (AIDS) across China...
March 2018: Tohoku Journal of Experimental Medicine
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