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https://www.readbyqxmd.com/read/28103460/-pneumocystis-pneumonia-in-107-hiv-infected-patients-admitted-to-the-department-of-infectious-diseases-at-santa-maria-hospital-lisbon-2002-2013
#1
Vilma Grilo, Aida Pereira
INTRODUCTION: Pneumocystis jirovecii pneumonia remains one of the most common opportunistic illnesses in patients infected with the human immunodeficiency virus. It is currently the most reported AIDS-defining infection in Portugal. The aims of this study were to analyze the features of a human immunodeficiency virus /Pneumocystis jirovecii pneumonia coinfected population, to compare it with the current literature, and to evaluate comparatively subpopulations of patients based on the previous knowledge of the human immunodeficiency virus infection, Pneumocystis jirovecii pneumonia diagnostic method and discharge results...
October 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/28100282/optimal-regimens-of-sulfamethoxazole-trimethoprim-for-chemoprophylaxis-of-pneumocystis-pneumonia-in-patients-with-systemic-rheumatic-diseases-results-from-a-non-blinded-randomized-controlled-trial
#2
Masako Utsunomiya, Hiroaki Dobashi, Toshio Odani, Kazuyoshi Saito, Naoto Yokogawa, Kenji Nagasaka, Kenchi Takenaka, Makoto Soejima, Takahiko Sugihara, Hiroyuki Hagiyama, Shinya Hirata, Kazuo Matsui, Yoshinori Nonomura, Masahiro Kondo, Fumihito Suzuki, Makoto Tomita, Mari Kihara, Waka Yokoyama, Fumio Hirano, Hayato Yamazaki, Ryoko Sakai, Toshihiro Nanki, Ryuji Koike, Hitoshi Kohsaka, Nobuyuki Miyasaka, Masayoshi Harigai
BACKGROUND: Sulfamethoxazole-trimethoprim (SMX/TMP) is a standard drug for the prophylaxis of Pneumocystis pneumonia (PJP) in immunosuppressed patients with systemic rheumatic diseases, but is sometimes discontinued due to adverse events (AEs). The objective of this non-blinded, randomized, 52-week non-inferiority trial was to quest an effective chemoprophylaxis regimen for PJP with a low drug discontinuation rate. Results at week 24 were reported. METHODS: Adult patients with systemic rheumatic diseases who started prednisolone ≥0...
January 18, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28088990/prevention-and-management-of-glucocorticoid-induced-side-effects-a-comprehensive-review-infectious-complications-and-vaccination-recommendations
#3
REVIEW
Avrom Caplan, Nicole Fett, Misha Rosenbach, Victoria P Werth, Robert G Micheletti
Part 3 of this 4-part continuing medical education series reviews several important infectious complications of corticosteroid use, including a focus on pneumocystis pneumonia (PCP) prophylaxis, tuberculosis, viral hepatitis, and other infections, followed by a discussion of vaccination recommendations in immunosuppressed patients.
February 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28080991/minimizing-fungal-disease-deaths-will-allow-the-unaids-target-of-reducing-annual-aids-deaths-below-500-000-by-2020-to-be-realized
#4
REVIEW
David W Denning
Deaths from AIDS (1 500 000 in 2013) have been falling more slowly than anticipated with improved access to antiretroviral therapy. Opportunistic infections account for most AIDS-related mortality, with a median age of death in the mid-30s. About 360 000 (24%) of AIDS deaths are attributed to tuberculosis. Fungal infections deaths in AIDS were estimated at more than 700 000 deaths (47%) annually. Rapid diagnostic tools and antifungal agents are available for these diseases and would likely have a major impact in reducing deaths...
December 5, 2016: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28074607/the-use-of-intravenous-pentamidine-for-the-prophylaxis-of-pneumocystis-pneumonia-in-pediatric-patients
#5
Matthijs D Kruizinga, Dorine Bresters, Frans J Smiers, Arjan C Lankester, Robbert G M Bredius
Pneumocystis jiroveci pneumonia was common in the immunocompromised host before the widespread use of prophylaxis. When trimethoprim-sulfamethoxazole is not tolerated, prophylaxis with intravenous pentamidine (IVP) may be initiated. We performed a retrospective analysis of all pediatric patients who received IVP regarding efficacy, safety, and reason for initiation. Of 106 patients included in our analysis, one patient tested positive for Pneumocystis DNA. Adverse events were reported in 18% of IVP courses, and main reason for initiation was cytopenia (59%)...
January 11, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28031260/immunization-with-pca1-protects-mice-against-pneumocystis-pneumonia-and-generates-antibody-to-pneumocystis-jirovecii
#6
Brenda L Tesini, Terry W Wright, Jane E Malone, Constantine G Haidaris, Martha Harber, Andrea J Sant, Jennifer L Nayak, Francis Gigliotti
Pneumocystis pneumonia (PcP) is a life-threatening infection that affects immunocompromised individuals. Nearly half of all PcP cases occur in those prescribed effective chemoprophylaxis, suggesting that additional preventive methods are needed. To this end, we have identified a unique mouse Pc surface protein, designated Pneumocystis cross-reactive antigen 1 (Pca1), as a potential vaccine candidate. Mice were immunized with a recombinant fusion protein containing Pca1. Subsequently, CD4(+) T cells were depleted and the mice were exposed to P...
December 28, 2016: Infection and Immunity
https://www.readbyqxmd.com/read/28019110/severe-kaposi-sarcoma-in-an-urban-public-hospital
#7
Shirin Kasturia, Clifford Gunthel, Cheng Zheng, Minh Ly Nguyen
INTRODUCTION: The national incidence of epidemic Kaposi Sarcoma (KS) has decreased dramatically since the availability of combined antiretroviral therapy (cART). Despite national trends, we continue to see admissions for KS. Methods: Electronic medical records were queried to identify patients with HIV who were admitted with active KS between 2010 and 2013 and records were reviewed to determine patient characteristics and factors affecting survival. Data were collected from all hospital admissions until death or May 1, 2015...
December 26, 2016: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28018911/a-quantitative-model-to-estimate-drug-resistance-in-pathogens
#8
Frazier N Baker, Melanie T Cushion, Aleksey Porollo
Pneumocystis pneumonia (PCP) is an opportunistic infection that occurs in humans and other mammals with debilitated immune systems. These infections are caused by fungi in the genus Pneumocystis, which are not susceptible to standard antifungal agents. Despite decades of research and drug development, the primary treatment and prophylaxis for PCP remains a combination of trimethoprim (TMP) and sulfamethoxazole (SMX) that targets two enzymes in folic acid biosynthesis, dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS), respectively...
December 2016: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/28012778/b-cell-and-antibody-responses-in-mice-induced-by-a-putative-cell-surface-peptidase-of-pneumocystis-murina-protect-against-experimental-infection
#9
Sanbao Ruan, Yang Cai, Alistair J Ramsay, David A Welsh, Karen Norris, Judd E Shellito
RATIONALE: Pneumocystis pneumonia is a major cause of morbidity and mortality in HIV-infected subjects, cancer patients undergoing chemotherapy and solid organ transplant recipients. No vaccine is currently available. By chemical labeling coupled with proteomic approach, we have identified a putative surface protein (SPD1, Broad Institute gene accession number PNEG_01848) derived from single suspended P. murina cysts. SPD1 was expressed in an insect cell line and tested for vaccine development...
January 23, 2017: Vaccine
https://www.readbyqxmd.com/read/28005039/-intrauterine-pneumocystis-infection
#10
E R Samitova, T N Ermak, I E Koltunov, A N Kislyakov, N V Karazhas, T N Rybalkina, M Yu Kornienko
Pneumocystosis is well known as an opportunistic infection that is presently most frequently registered in patients with HIV infection and in those with other immunodeficiency states. Earlier, after the Second World War, Pneumocystis pneumonia was most commonly detected in debilitated and premature children; nosocomial outbreaks of pneumocystosis were studied in detail in the 1960s and 1970s. The pathogen is transmitted through the air, but a number of references indicate that it can be transmitted through the placenta...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27997332/delivering-on-antimicrobial-resistance-agenda-not-possible-without-improving-fungal-diagnostic-capabilities
#11
David W Denning, David S Perlin, Eavan G Muldoon, Arnaldo Lopes Colombo, Arunaloke Chakrabarti, Malcolm D Richardson, Tania C Sorrell
Antimicrobial resistance, a major public health concern, largely arises from excess use of antibiotic and antifungal drugs. Lack of routine diagnostic testing for fungal diseases exacerbates the problem of antimicrobial drug empiricism, both antibiotic and antifungal. In support of this contention, we cite 4 common clinical situations that illustrate this problem: 1) inaccurate diagnosis of fungal sepsis in hospitals and intensive care units, resulting in inappropriate use of broad-spectrum antibacterial drugs in patients with invasive candidiasis; 2) failure to diagnose chronic pulmonary aspergillosis in patients with smear-negative pulmonary tuberculosis; 3) misdiagnosis of fungal asthma, resulting in unnecessary treatment with antibacterial drugs instead of antifungal drugs and missed diagnoses of life-threatening invasive aspergillosis in patients with chronic obstructive pulmonary disease; and 4) overtreatment and undertreatment of Pneumocystis pneumonia in HIV-positive patients...
February 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/27993972/differential-macrophage-polarization-from-pneumocystis-in-immunocompetent-and-immunosuppressed-hosts-potential-adjunctive-therapy-during-pneumonia
#12
Vijayalakshmi Nandakumar, Deanne Hebrink, Paige Jenson, Theodore Kottom, Andrew Limper
We explored differential polarization of macrophages during infection using a rat model of Pneumocystis pneumonia. We observed enhanced pulmonary M1 macrophage polarization in immunosuppressed (IS) hosts, but an M2 predominant response in immunocompetent (IC) hosts following Pneumocystis carinii (Pc) challenge. Increased inflammation and iNOS levels characterized the M1 response. However, macrophage ability to produce nitric oxide was defective. In contrast, the lungs of IC animals revealed a prominent M2 gene signature and these macrophages effectively elicited an oxidative burst associated with clearance of Pneumocystis In addition, during Pc-infection the expression of Dectin-1, a critical receptor for recognition and clearance of Pc, was upregulated in macrophages of IC animals but was suppressed in IS animals...
December 19, 2016: Infection and Immunity
https://www.readbyqxmd.com/read/27990117/a-case-of-proliferative-diabetic-retinopathy-with-hiv-infection-in-which-haart-possibly-influenced-the-prognosis-of-visual-function
#13
Takakuni Kitagaki, Takaki Sato, Junko Hirai, Daisaku Kimura, Keigo Kakurai, Masanori Fukumoto, Kensuke Tajiri, Takatoshi Kobayashi, Teruyo Kida, Shota Kojima, Tsunehiko Ikeda
BACKGROUND: We report on a patient with proliferative diabetic retinopathy (PDR) and human immunodeficiency virus (HIV) infection who exhibited extremely active PDR followed by a rapid onset of blindness in the right eye. The progression of visual disturbance in the patient's left eye was slowed after starting highly active anti-retroviral therapy (HAART), and vision in that eye was rescued after vitrectomy. CASE REPORT: A 72-year-old male developed pneumocystis carinii pneumonia stemming from an HIV infection and began HAART at the Department of Hematology, Osaka Medical College, Takatsuki City, Japan...
September 2016: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/27965450/functional-characterization-of-pneumocystis-carinii-inositol-transporter-1
#14
Melanie T Cushion, Margaret S Collins, Thomas Sesterhenn, Aleksey Porollo, Anish Kizhakkekkara Vadukoot, Edward J Merino
: Fungi in the genus Pneumocystis live in the lungs of mammals, where they can cause a fatal pneumonia (PCP [Pneumocystis pneumonia]) in hosts with compromised immune systems. The absence of a continuous in vitro culture system for any species of Pneumocystis has led to limited understanding of these fungi, especially for the discovery of new therapies. We recently reported that Pneumocystis carinii, Pneumocystis murina, and most significantly, Pneumocystis jirovecii lack both enzymes necessary for myo-inositol biosynthesis but contain genes with homologies to fungal myo-inositol transporters...
December 13, 2016: MBio
https://www.readbyqxmd.com/read/27951623/clinical-significance-of-positive-pneumocystis-jirovecii-polymerase-chain-reaction-in-non-human-immunodeficiency-virus-immunocompromised-patients-in-a-real-practice
#15
Hea Yon Lee, Hye Seon Kang, Hwa Young Lee, Chin Kook Rhee, Sook Young Lee, Seok Chan Kim, Seung Joon Kim, Yeon Joon Park, Young Kyoon Kim, Ji Young Kang
Background/Aims: Pneumocystis jirovecii polymerase chain reaction (PCR) can be helpful in diagnosing Pneumocystis pneumonia (PCP); however it has limitations. We evaluated the prevalence of positive P. jirovecii PCR from non-human immunodeficiency virus (HIV) immunocompromised patients and tried to determine the risk of PCP development. Methods: Between May 2009 and September 2012, P. jirovecii PCR was performed in bronchoscopic specimens from 1,231 adult non-HIV immunocompromised patients suspected of respiratory infection...
December 13, 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/27927829/lesson-of-the-month-1-lobar-pulmonary-consolidation-in-an-immunocompromised-host
#16
Daniel J Reynolds, Carl A Andersen, Sumedh S Hoskote, Hee Eun Lee, Aditya Raghunathan, Sanjay Kalra, Andrew H Limper
A 19-year-old male with a history of idiopathic panuveitis, currently taking methotrexate and infliximab, presented to our institution with 6 weeks of cough, dyspnoea and fevers. He had failed outpatient antimicrobial therapy. Computerised tomography (CT) of the chest revealed the presence of a lobar pneumonia and he was treated with broad spectrum antibiotics, which did not improve his symptoms. Bronchoalveolar lavage was performed with a transbronchial lung biopsy because of the diagnostic uncertainty of the patient's presentation...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27925857/analysis-of-the-intestinal-microbial-community-and-inferred-functional-capacities-during-the-host-response-to-pneumocystis-pneumonia
#17
Derrick R Samuelson, Tysheena P Charles, Nicholas M de la Rua, Christopher M Taylor, Eugene E Blanchard, Meng Luo, Judd E Shellito, David A Welsh
BACKGROUND: Pneumocystis pneumonia is a major cause of morbidity and mortality in patients infected with HIV/AIDS. In this study, we evaluated the intestinal microbial communities associated with the development of experimental Pneumocystis pneumonia, as there is growing evidence that the intestinal microbiota is critical for host defense against fungal pathogens. METHODS: C57BL/6 mice were infected with live Pneumocystis murina (P. murina) via intratracheal inoculation and sacrificed 7 and 14 days postinfection for microbiota analysis...
December 7, 2016: Experimental Lung Research
https://www.readbyqxmd.com/read/27904052/recent-advances-in-the-diagnosis-of-pneumocystis-pneumonia
#18
Yinggai Song, Yi Ren, Xiaowen Wang, Ruoyu Li
Pneumocystis jirovecii is a prototypical opportunistic pathogen, causing an asymptomatic or mild infection in normal hosts and fulminating pneumonia (Pneumocystis pneumonia, PCP) in immunocompromised hosts. PCP is a leading cause of morbidity and mortality in immunocompromised patients such as AIDS patients. Microscopic detection of cysts and trophic forms of P. jirovecii in respiratory secretions is simple and useful but may underestimate the P. jirovecii infection. Conventional polymerase chain reaction (PCR) and nested PCR increase the sensitivity and specificity to identify PCP and provide an approach to discriminate PCP from pulmonary P...
2016: Medical Mycology Journal
https://www.readbyqxmd.com/read/27890947/profile-of-pneumocystis-infection-in-a-tertiary-care-institute-in-north-india
#19
Ravinder Kaur, Pragyan Swagatika Panda, Richa Dewan
CONTEXT: Pneumocystis jirovecii pneumonia (PcP) is still remains a common opportunistic disease in human immunodeficiency virus (HIV) infected individuals. Study on PcP in developing countries are scarce. AIMS: To study the occurrence of P. jirovecii infection in clinically suspected individuals in a tertiary care institute. SETTINGS AND DESIGN: Retrospective study conducted in a tertiary care hospital. MATERIALS AND METHODS: Two years data regarding respiratory sample analysis, HIV status, and cluster of differentiation 4 (CD4) cell count of clinically suspected pneumocystis infection patients with known/unknown HIV status were analyzed...
July 2016: Indian Journal of Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/27890037/grouped-cases-of-pulmonary-pneumocystosis-after-solid-organ-transplantation-advantages-of-coordination-by-an-infectious-diseases-unit-for-overall-management-and-epidemiological-monitoring
#20
Claire Wintenberger, Daniele Maubon, Elena Charpentier, John Rendu, Patricia Pavese, Caroline Augier, Paolo Malvezzi, Boubou Camara, Marie-Reine Mallaret, Laurence Bouillet, Olivier Epaulard
OBJECTIVE To determine the origin of grouped cases of Pneumocystis pneumonia in solid-organ transplant recipients at our institution. DESIGN A case series with clinical examinations, genotyping, and an epidemiological survey. SETTING A university hospital in France. PATIENTS We report 12 solid-organ transplant recipients with successive cases of Pneumocystis pneumonia that occurred over 3 years; 10 of these cases occurred in a single year. METHODS We used molecular typing of P. jirovecii strains by multilocus sequence typing and clinical epidemiological survey to determine potential dates and places of transmission...
February 2017: Infection Control and Hospital Epidemiology
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