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https://www.readbyqxmd.com/read/29054940/rare-presentation-of-an-old-bug
#1
Hasan Ahmad Hasan Albitar, Alice Gallo de Moraes, Kaiser G Lim
We highlight a rare presentation of Legionella infection in a 77-year-old woman with a clinical diagnosis of giant cell arteritis 2 months prior to presentation. She was started on 60 mg prednisone that was tapered to 10 mg after 4 weeks following her diagnosis. She presented with a 1-month progressive dyspnoea in the absence of any other symptoms. Her exposure history was significant only for a recent trip to Florida where she stayed at a hotel. Initial laboratory workup was significant for hyponatraemia (127 mmol/L)...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29039305/changing-epidemiology-of-pneumocystis-pneumonia-northern-ireland-uk-and-implications-for-prevention-1-july-2011-31-july-2012
#2
Lynsey Patterson, Peter Coyle, Tanya Curran, Neville Q Verlander, Jillian Johnston
PURPOSE: There is a lack of consensus about which non-human immunodeficiency virus (HIV) patient groups would benefit from prophylaxis. Here, we analysed an enhanced Pneumocystis jirovecii database to describe the epidemiology of Pneumocystis pneumonia (PCP) and P. jirovecii colonizations in Northern Ireland (NI) with a view to identifying risk groups who may benefit from prophylaxis. METHODOLOGY: We prospectively collected information on demographics, clinical severity and clinical features for all hospital inpatients in NI aged ≥18 years with P...
October 17, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29033413/multiple-lung-cysts-due-to-pneumocystis-jirovecii-pneumonia
#3
Kazuaki Fukushima, Keishiro Yajima
No abstract text is available yet for this article.
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29030378/worsening-guillain-barr%C3%A3-syndrome-harbinger-of-iris-in-hiv
#4
Neeharika L Mathukumalli, Niloufer Ali, Meena A Kanikannan, Sireesha Yareeda
We report an HIV patient aged 38 years with acute inflammatory demyelinating polyradiculoneuropathy subtype of Guillain-Barré syndrome (GBS) as the only manifestation of seroconversion and worsening of GBS being the harbinger of immune reconstitution inflammatory syndrome (IRIS). To date, only 5 cases of GBS during IRIS are reported. They manifested either during the third week or later after starting highly active antiretroviral therapy (HAART). Our patient witnessed worsening weakness by fifth day after starting HAART, even before the occurrence of Pneumocystis jirovecii pneumonia, cautioning one of the impending serious complications of IRIS and helped us initiate steroids at an early date...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29029010/call-for-action-invasive-fungal-infections-associated-with-ibrutinib-and-other-small-molecule-kinase-inhibitors-targeting-immune-signaling-pathways
#5
Georgios Chamilos, Michail S Lionakis, Dimitrios P Kontoyiannis
Opportunistic infections caused by Pneumocystis jirovecii, Cryptococcus neoformans, and ubiquitous airborne filamentous fungi have been recently reported in patients with hematological cancers historically considered at low risk for invasive fungal infections (IFIs), after receipt of the Bruton tyrosine kinase inhibitor ibrutinib. The spectrum and severity of IFIs often observed in these patients implies the presence of a complex immunodeficiency that may not be solely attributed to mere inhibition of Bruton tyrosine kinase...
September 27, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28992910/extreme-tetralogy-of-fallot-with-polycythemia-in-a-ferret-mustela-putorius-furo
#6
Sara Dias, Marta Planellas, Albert Canturri, Jaume Martorell
A 5-month-old, intact male ferret (Mustela putorius furo) was presented with apathy, tachypnea and exercise intolerance. On initial physical examination, tachypnea and cyanosis were the two primary clinical signs detected. The complete blood count also revealed a severe polycythemia, with lymphopenia, neutrophilia and eosinophilia. Further diagnostic imaging tests were performed. The thoracic radiographs revealed cardiomegaly and a diffuse alveolar pulmonary pattern. Consequently, an echocardiography was performed and showed an interventricular septal defect, pulmonic artery occlusion, overriding of the aorta and right ventricle hypertrophy...
June 2017: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28992298/incidence-of-pneumocystis-jirovecii-and-adverse-events-associated-with-pneumocystis-prophylaxis-in-children-receiving-glucocorticoids
#7
Matthew L Basiaga, Michelle E Ross, Jeffrey S Gerber, Alexis Ogdie
Background: Antimicrobial prophylaxis is indicated to prevent Pneumocystis jirovecii pneumonia (PJP) in profoundly immunosuppressed children. The incidence of PJP infection in children with chronic glucocorticoid exposure is unknown, and PJP prophylaxis has been associated with adverse events. We hypothesized that PJP infection is rare in children without human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), cancer, or a transplant history who are using chronic glucocorticoids and that those exposed to PJP prophylaxis are more likely to experience a cutaneous hypersensitivity reaction or myelosuppression than unexposed patients...
July 13, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28986117/screening-prophylaxis-and-counselling-before-the-start-of-biological-therapies-a-practical-approach-focused-on-ibd-patients
#8
REVIEW
Cândida Abreu, António Sarmento, Fernando Magro
The standard of care in the management of immune-mediated inflammatory conditions relies on immunomodulators, glucocorticoids, and biologicals (including anti-tumour necrosis factor -α and other monoclonal antibodies). These agents have an overall favourable benefit/risk ratio; however, they modulate the immune response as part of their mechanisms of action, and therefore they may increase the risk of developing infections, particularly in older patients or in patients with concomitant corticosteroids. Some of these infections may be preventable by immunization, chemoprophylaxis or counselling...
September 12, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28979539/co-trimoxazole-induced-hypoglycaemia-in-an-immunosuppressed-intensive-care-patient
#9
Katherine A Richards, Simon Raby
An 18-year-old female inpatient on a neurosciences intensive care unitwith new onset super-refractory epilepsy became hypoglycaemic 48 h after commencing co-trimoxazole. She had been placed on this for prophylaxis against Pneumocystis jiroveci infection in the context of significant immunosuppression with high-dose corticosteroid therapy. In order to maintain glucose control, she required a continuous infusion of 10% dextrose at rates of 15-25 ml/h. Recurrent attempts to wean this were limited by further hypoglycaemia, until she spontaneously regained normoglycaemia after 73 days...
February 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28979537/tension-pneumomediastinum-a-literal-form-of-chest-tightness
#10
David J Clancy, Andrew S Lane, Peter W Flynn, Ian M Seppelt
Tension pneumomediastinum is a rare and life-threatening complication of mediastinal emphysema which can occur with mechanical ventilation. We present a case of tension mediastinum associated with mechanical ventilation in a patient with Acute Respiratory Distress Syndrome due to Pneumocystis jirovecii pneumonia. We discuss the mechanism and pathophysiology of tension pneumomediastinum, the potential association with Pneumocystis jirovecii pneumonia and recruitment manouvres, and its definitive emergency treatment...
February 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28978595/hiv-related-pneumocystis-jirovecii-pneumonia-managed-with-caspofungin-and-veno-venous-extracorporeal-membrane-oxygenation-rescue-therapy
#11
Nathaniel Lee, David Lawrence, Brijesh Patel, Stephane Ledot
Patients with pneumocystis pneumonia have a risk of progressing to acute respiratory failure necessitating admission to intensive care. The case described is of a patient with a newly diagnosed HIV infection presenting with pneumocystis pneumonia. Despite initiating the appropriate pharmacological treatment the patient's clinical condition deteriorated, and required both rescue pharmacological therapy with echinocandins as well as respiratory support with extracorporeal membrane oxygenation therapy. The patient recovered well on ventilator and circulatory support despite a long weaning process complicated by sequelae common to pneumocystis pneumonia...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28948369/acute-hypoxemic-respiratory-failure-in-immunocompromised-patients-the-efraim-multinational-prospective-cohort-study
#12
Elie Azoulay, Peter Pickkers, Marcio Soares, Anders Perner, Jordi Rello, Philippe R Bauer, Andry van de Louw, Pleun Hemelaar, Virginie Lemiale, Fabio Silvio Taccone, Ignacio Martin Loeches, Tine Sylvest Meyhoff, Jorge Salluh, Peter Schellongowski, Katerina Rusinova, Nicolas Terzi, Sangeeta Mehta, Massimo Antonelli, Achille Kouatchet, Andreas Barratt-Due, Miia Valkonen, Precious Pearl Landburg, Fabrice Bruneel, Ramin Brandt Bukan, Frédéric Pène, Victoria Metaxa, Anne Sophie Moreau, Virginie Souppart, Gaston Burghi, Christophe Girault, Ulysses V A Silva, Luca Montini, François Barbier, Lene B Nielsen, Benjamin Gaborit, Djamel Mokart, Sylvie Chevret
BACKGROUND: In immunocompromised patients with acute hypoxemic respiratory failure (ARF), initial management aims primarily to avoid invasive mechanical ventilation (IMV). METHODS: To assess the impact of initial management on IMV and mortality rates, we performed a multinational observational prospective cohort study in 16 countries (68 centers). RESULTS: A total of 1611 patients were enrolled (hematological malignancies 51.9%, solid tumors 35...
September 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28945819/comparison-of-pneumocystis-nucleic-acid-and-antibody-profiles-and-their-associations-with-other-respiratory-pathogens-in-two-austrian-pig-herds
#13
COMPARATIVE STUDY
Christiane Weissenbacher-Lang, Nora Nedorost, Christian Knecht, Isabel Hennig-Pauka, Mathias Huber, Thomas Voglmayr, Herbert Weissenböck
Pneumocystis carinii f. sp. suis (PCS) nucleic acid and antibody profiles on two Austrian-farrow-to-finish farms were investigated. Furthermore, associations with other respiratory pathogens were evaluated. Respiratory specimen and sera from pigs of five age classes between the 1st week and the 3rd month of life as well as samples from sows were analyzed. On Farm A, PCS infection occurred early in life. The suckling piglets were already infected in the 1st week of life and the pigs remained positive until the 3rd month of life...
2017: PloS One
https://www.readbyqxmd.com/read/28945326/reliable-differentiation-of-pneumocystis-pneumonia-from-pneumocystis-colonization-by-quantification-of-major-surface-glycoprotein-gene-using-real-time-polymerase-chain-reaction
#14
Shivaprakash M Rudramurthy, Megha Sharma, Madhubala Sharma, Pankaj Rawat, Anup Ghosh, V Lakshmishree, Ritesh Aggarwal, Meenu Singh, Arunaloke Chakrabarti
BACKGROUND: A clear differentiation between pneumonia due to Pneumocystis jirovecii and 'colonization' is required for optimal case management. OBJECTIVE: A quantification of fungal burden using major surface glycoprotein (MSG) gene-based real-time PCR was undertaken for the same. METHODS: Lower respiratory tract samples collected from 104 patients of clinically suspected Pneumocystis pneumonia (PCP) were subjected to quantitative PCR using MSG gene...
September 25, 2017: Mycoses
https://www.readbyqxmd.com/read/28943270/investigation-of-nosocomial-pneumocystis-infections-usefulness-of-longitudinal-screening-of-epidemic-and-post-epidemic-pneumocystis-genotypes
#15
Gilles Nevez, Solène Le Gal, Natacha Noel, Alain Wynckel, Antoine Huguenin, Yohann Le Govic, Laurence Pougnet, Michèle Virmaux, Dominique Toubas, Odile Bajolet
BACKGROUND: Twenty-five patients, of whom 22 were renal transplant recipients, developed Pneumocystis jirovecii (P.jirovecii) infections at the nephrology department of Reims University Hospital (France) from September 2008 through October 2009, whereas only four sporadic cases had been diagnosed in this department over the 14 previous years. AIM: This outbreak was investigated by analyzing patient encounters and P.jirovecii types. METHODS: A transmission map was drawn up...
September 21, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28938676/risk-factors-for-mortality-from-pneumocystis-carinii-pneumonia-pcp-in-non-hiv-patients-a-meta-analysis
#16
Yao Liu, Lili Su, Shu-Juan Jiang, Hui Qu
The number of patients with non-human immunodeficiency virus (HIV) related pneumocystis carinii pneumonia (PCP) is increasing with widespread immunosuppressive treatment. We performed a meta-analysis to describe the clinical characteristics and factors associated with outcomes of PCP in HIV-negative patients. A total of 13 studies including 867 patients with non-HIV related PCP was included. The overall mortality for non-HIV patients with PCP was 30.6%. The most common underlying disorder for the development of PCP is hematological malignancies (29...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28932610/pneumocystis-pneumonia-in-non-hiv-pregnant-women-receiving-chemotherapy-for-malignant-lymphoma-two-case-reports
#17
Yuki Fukutani, Yoshitsugu Chigusa, Eiji Kondoh, Kaoru Kawasaki, Shingo Io, Noriomi Matsumura
Pneumocystis pneumonia (PCP) is a life-threatening opportunistic infection that sometimes occurs in immunocompromised patients with human immunodeficiency virus (HIV). Here, we report two extremely rare cases of PCP in non-HIV pregnant women who underwent chemotherapy for malignant lymphoma. Case  1 is a 34-year-old primigravida who was diagnosed with Hodgkin's lymphoma. She received ABVD chemotherapy and developed PCP at 37 weeks of gestation. After the onset of PCP, emergent cesarean section was performed due to a nonreassuring fetal status...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28923644/combination-of-echinocandins-and-trimethoprim-sulfamethoxazole-for-the-treatment-of-pneumocystis-jiroveci-pneumonia-after-heart-transplantation
#18
Y-M Lu, Y-T Lee, H-C Chang, H-S Yang, C-Y Chang, C-M Huang, J Wei
BACKGROUND: The echinocandins have shown anti-Pneumocystis jiroveci activity in nonhuman animal models; however, the corresponding human clinical experience has been rarely reported. We report a clinical picture of P jiroveci pneumonia (PJP) and determine the effects of concomitant therapy with echinocandins and trimethoprim (TMP)-sulfamethoxazole (SMZ). METHODS: We investigated a retrospective case series of heart transplantation (HT) recipients with PJP from July 1988 to December 2015...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28920631/pneumocystis-jirovecii-genotyping-experience-in-a-tertiary-care-hospital-in-northern-italy
#19
Pietro Pini, Carlotta F Orsi, Annunziata La Regina, Samuele Peppoloni, Federica Berrilli, Elisabetta Blasi, David Di Cave
Respiratory samples from Pneumocystis jirovecii pneumonia (PJP) cases collected at a tertiary-care university hospital in Modena were analyzed for the presence of specific polymorphisms in the mitochondrial large subunit ribosomal RNA (mtLSU-rRNA). Retrospectively, 57 cases were selected in a six-year period and 34 out of the 57 processed BAL samples returned PCR positive results, thus allowing further molecular analysis. The following P.jirovecii genotype distribution was observed: genotype 3 (50%), genotype 2 (23%), genotype 1 (18%), genotypes 1 or 4 (9%)...
July 2017: New Microbiologica
https://www.readbyqxmd.com/read/28918972/-mycological-and-parasitological-examinations-in-the-management-of-lung-infections
#20
REVIEW
L Lachaud, J P Gangneux
Pulmonary parasitic diseases are rare whereas pulmonary fungal infections are increasing. The diversity of clinical presentations requires laboratory tests to confirm the diagnosis. Direct examination of lung samples and antibody detection are the basis of parasitological diagnosis. With regard to mycoses, the range of biological tests is broader. The conventional mycological examination allows identification of any type of fungus except Pneumocystis jirovecii. Its specificity is excellent but it lacks sensitivity...
September 14, 2017: Revue des Maladies Respiratoires
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