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pneumocystis pneumonia

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https://www.readbyqxmd.com/read/28920631/pneumocystis-jirovecii-genotyping-experience-in-a-tertiary-care-hospital-in-northern-italy
#1
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/28912409/-a-case-of-pneumocystis-pneumonia-during-adjuvant-dose-dense-chemotherapy-for-breast-cancer
#2
Noriko Sagawa, Norie Abe, Tomohiko Ishimine, Hisamitsu Zaha
A 47-year-old woman received adjuvant chemotherapy for breast cancer. On the 13th day of 4 courses of dose-dense AC therapy, she developed a fever. She was orally administered an antibioticfor febrile neutropenia treatment. She showed no improvement of symptoms and gradually presented with new symptoms, including a non-productive cough and dyspnea. After admission, she underwent a further examination, and was provided a diagnosis of pneumocystis pneumonia. It is reported that patients receiving chemotherapy for solid tumors are less likely to develop opportunistic infections...
September 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28906322/the-effect-of-ophthalmic-artery-chemosurgery-on-immune-function-in-retinoblastoma-patients-a-single-institution-retrospective-analysis
#3
Cheryl Fischer, Mary Petriccione, Stephanie Vitolano, Edith Guarini, Mary Elizabeth Davis, Ira J Dunkel
BACKGROUND: Ophthalmic artery chemosurgery (OAC) is associated with grade 3 and 4 neutropenia, however the effect on T-cell number and function is unknown. The purpose of this retrospective review was to confirm that patients treated with OAC do not develop immunosuppression warranting Pneumocystis pneumonia prophylaxis. PROCEDURE: IRB approval was obtained for a single center retrospective review of immune function tests in retinoblastoma patients who received OAC...
September 12, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28905389/the-first-reported-case-of-concurrent-trimethoprim-sulfamethoxazole-induced-immune-hemolytic-anemia-and-thrombocytopenia
#4
Yevgeniy A Linnik, Edison W Tsui, Isabella W Martin, Zbigniew M Szczepiorkowski, Gregory A Denomme, Jerome L Gottschall, John M Hill, Nancy M Dunbar
BACKGROUND: Drug-induced immune hemolytic anemia (DIIHA) and drug-induced immune thrombocytopenia (DIIT) are rare but dangerous complications of pharmacotherapy that may be underrecognized in hematopoietic stem cell transplant (HSCT) patients due to overlap of signs and symptoms with those of more common disease processes. CASE REPORT: A 61-year-old woman with NK-cell deficiency and GATA-2-associated myelodysplastic syndrome, status post-recent allogeneic HSCT (Day +58), presented with 3 days of acute-onset severe back pain, muscle cramps, and increasingly dark urine...
September 14, 2017: Transfusion
https://www.readbyqxmd.com/read/28898546/taking-the-challenge-a-protocolized-approach-to-optimize-pneumocystis-pneumonia-prophylaxis-in-renal-transplant-recipients
#5
K F Urbancic, F Ierino, E Phillips, P F Mount, A Mahony, J A Trubiano
While trimethoprim-sulfamethoxazole is considered first-line therapy for Pneumocystis pneumonia prevention in renal transplant recipients, reported adverse drug reactions may limit use and increase reliance on costly and less effective alternatives, often aerosolized pentamidine. We report our experience implementing a protocolized approach to trimethoprim-sulfamethoxazole adverse drug reaction assessment and rechallenge to optimize prophylaxis in this patient cohort. We retrospectively reviewed 119 patients receiving Pneumocystis pneumonia prophylaxis prior to and after protocol implementation...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28893787/efficacy-and-toxicity-of-low-dose-trimethoprim-sulfamethoxazole-for-the-treatment-of-pneumocystis-pneumonia-in-patients-without-human-immunodeficiency-virus-infection-a-four-center-retrospective-study
#6
Makoto Kosaka, Atsuhito Ushiki, Yuichi Ikuyama, Kazuya Hirai, Akemi Matsuo, Tsutomu Hachiya, Masayuki Hanaoka
Background and objectives: The dose of trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment of pneumocystis pneumonia (PCP) in patients without human immunodeficiency virus (HIV) infection has not been verified. The aim of this study was to investigate the efficacy and toxicity of low-dose TMP-SMX regimen in such patients.Methods: A retrospective study was conducted in four hospitals. We reviewed the medical records of patients with PCP but not HIV (non-HIV-PCP), who were treated with TMP-SMX between 2003 and 2016...
September 11, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28892896/detection-of-cytomegalovirus-in-bronchoalveolar-lavage-fluid-from-hiv-positive-individuals-with-community-acquired-pneumonia
#7
Arati Mane, Pankaj Gujar, Shraddha Gaikwad, Tilak Dhamgaye, Arun Risbud
INTRODUCTION: Cytomegalovirus (CMV) pneumonia is one of the frequent viral pneumonia reported in persons with HIV infection. Knowledge of pulmonary CMV infection is important for deciding appropriate diagnostic strategies. However, there is scanty literature addressing the role of CMV aetiology among HIV positive individuals presenting with Community Acquired Pneumonia (CAP) using Bronchoalveolar Lavage (BAL) samples from India. AIM: To detect CMV in BAL fluid from HIV-positive individuals presenting with CAP...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28886250/dectin-2-is-a-c-type-lectin-receptor-that-recognizes-pneumocystis-and-participates-in-innate-immune-responses
#8
Theodore J Kottom, Deanne M Hebrink, Paige E Jenson, Paige L Marsolek, Marcel Wüthrich, Huafeng Wang, Bruce Klein, Sho Yamasaki, Andrew H Limper
Pneumocystis remains an important fungal pathogen causing life-threatening pneumonia in patients with AIDS and malignancy. Lung fungal pathogens are recognized by C-type Lectin Receptors (CLRs), which bind specific ligands and stimulate innate immune responses. Previously, a role for the CLR Dectin-1 has been shown to mediate immune responses to Pneumocystis spp. For this reason, we investigated a potential role for Dectin-2. Rats with Pneumocystis pneumonia (PCP) exhibited elevated Dectin-2 mRNA levels. Soluble Dectin-2 CRD fusions protein showed binding to intact Pneumocystis carinii (Pc) and to native Pneumocystis major surface glycoprotein/glycoprotein A (Msg/gpA)...
September 8, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28881516/-effectiveness-and-safety-of-rituximab-for-children-with-autoimmune-diseases-of-the-nervous-system
#9
Z Fu, X H Bao, Y Wu, J Zhou, Y H Zhang, Y Zhang, T Y Ji, Y Chen
Objective: To assess the effectiveness and safety of rituximab in Chinese children with autoimmune diseases of the nervous system. Method: An ambispective cohort study enrolled patients with refractory and(or) relapse autoimmune diseases of nervous system from June 2010 to June 2016 in Peking University First Hospital.These patients failed to respond to steroids and(or)intravenous immunoglobulin (IVIG) were treated with rituximab and seen for follow-up visits once every 3 months.The effectiveness was assessed by modified Rankin scale (mRs) and the annualized relapse rate...
September 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28879093/refractory-acute-respiratory-failure-due-to-pneumocystis-jiroveci-pcp-and-cytomegalovirus-cmv-pneumonitis-a-case-report-and-review-of-literature
#10
Kairav Shah, Kartikeya Cherabuddi, Stacy G Beal, Gautam Kalyatanda
BACKGROUND: Opportunistic infections with Pneumocystis jiroveci pneumonia (PCP) are common in patients with HIV (human immunodeficiency virus) and are encountered once the CD4 count decreases below 200 cells/mm3. Cytomegalovirus (CMV) tends to cause disease once the CD4 count drops below 50 cells/mm3. CMV pneumonitis is not common in this population. However, detecting its presence in broncho-alveolar lavage (BAL) fluid has been associated with increased morbidity and mortality. The role of antiviral therapy against CMV remains unclear...
2017: IDCases
https://www.readbyqxmd.com/read/28861334/severe-pneumocystis-jiroveci-pneumonia-in-a-patient-on-temozolomide-therapy-a-case-report-and-review-of-literature
#11
Babar Ahmad Khan, Sania Khan, Benjamin White, Ambika Eranki
A 66 year old man was diagnosed with CNS diffuse large B-cell lymphoma, and underwent treatment with Temozolomide, Dexamethasone, Rituximab, and radiation therapy, and prolonged steroid taper with Dexamethasone. Approximately one month after this, he presented with severe acute hypoxemic respiratory failure, and was admitted to the Medical Intensive Care Unit. Imaging showed diffuse ground glass opacities. Patient underwent diagnostic bronchoalveolar lavage which was positive for Pneumocystis jiroveci. He did not respond well to appropriate therapy and was transitioned to comfort care per his family's wishes, and expired...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28854309/determining-the-incidence-of-pneumocystis-pneumonia-in-patients-with-autoimmune-blistering-diseases-not-receiving-routine-prophylaxis
#12
Kyle T Amber, Aniek Lamberts, Farzan Solimani, Arianna F Agnoletti, Dario Didona, Ilona Euverman, Emanuele Cozzani, Lee Haur Yueh, Giovanni Di Zenzo, Yael Anne Leshem, Daniel Mimouni, Michael Hertl, Barbara Horvath
Importance: Pneumocystis pneumonia (PCP) is a potentially lethal opportunistic infection that primary prophylaxis can help prevent. The risk of prophylactic therapy must be weighed against the incidence of PCP in the patient population. Prophylaxis most frequently involves trimethoprim-sulfamethoxazole, with second-line therapies, including atovaquone, dapsone, and pentamide. The indication for prophylaxis in immunocompromised patients without HIV is less well defined. Previously, an incidence of at least 3...
August 30, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28852481/infectious-complications-of-rituximab-therapy-in-renal-disease
#13
Andrew Nixon, Leanne Ogden, Alexander Woywodt, Ajay Dhaygude
Rituximab, an anti-CD20 monoclonal antibody, was originally used to treat B-cell malignancies. Its use has significantly increased in recent years, as it is now also used to treat a variety of autoimmune diseases including rheumatoid arthritis and ANCA-associated vasculitis (AAV). Initial studies suggested that the adverse effects of rituximab were minimal. Though the risk of malignancy with rituximab-based immunosuppressive regimens appears similar to that of the general population, there are now concerns regarding the risk of infectious complications...
August 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28851493/evaluation-of-quantitative-ftd-pneumocystis-jirovecii-kit-for-pneumocystis-infection-diagnosis
#14
Gautier Hoarau, Solène Le Gal, Patricia Zunic, Patrice Poubeau, Emmanuel Antok, Julien Jaubert, Gilles Nevez, Sandrine Picot
We evaluated the Fast track Diagnostics (FTD) Pneumocystis PCR kit, targeting the mitochondrial large subunit ribosomal RNA gene (mtLSU rRNA) of Pneumocystis jirovecii (P. jirovecii). A hundred and thirty-three patients were prospectively enrolled. Respiratory specimens were examined using both microscopy and the PCR assay. Twenty-six patients led to P. jirovecii detection. Fourteen patients presented with Pneumocystis pneumonia (PCP) whereas 12 patients were considered to be colonized. The median copy numbers in bronchoalveolar lavage fluid were significantly different in the PCP and colonization groups (1...
August 9, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28843641/a-study-on-the-colonization-of-pneumocystis-jirovecii-among-outpatients-during-cancer-chemotherapy-and-among-healthy-smokers
#15
Shun Takemoto, Megumi Ebara, Shinji Hasebe, Yoshihiro Yakushijin
AIMS: Pneumocystis Jirovecii (PJ) is regarded as an agent of fungal infection and in cases of pneumocystis pneumonia (PCP) in immune-compromised patients including cancer patients. It is not clear what kinds of cancer, treatments, and environment need prophylaxis for PCP. In this study, we have analyzed the detectability of PJ DNA from sputum, and discussed prophylaxis and risk factors regarding PCP. METHODS: A total of forty-nine materials (twenty-four from outpatients during cancer chemotherapies and twenty-five from healthy control subjects) was collected...
August 23, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28835429/a-rare-case-of-pulmonary-toxoplasmosis-in-a-patient-with-undifferentiated-inflammatory-arthritis-on-chronic-methotrexate-and-corticosteroid-therapy
#16
Abdullateef Abdulkareem, Ryan Steven D'Souza, Nitin Patel, Anthony A Donato
Pulmonary toxoplasmosis is a serious pulmonary condition caused by the protozoan Toxoplasma gondii It typically affects immunocompromised patients presenting acutely with cough, fever, myalgias, arthralgias and lymphadenopathy, and chronically with persistent cough and dyspnoea. Because of its protean features, it can mimic many more common lung conditions in the immunocompromised patient, including atypical pneumonia, Pneumocystis pneumonia and interstitial lung disease. In this article, we present the case of a 55-year-old woman who presented to our hospital with persistent dyspnoea and cough, initially suspected to have an arthritis-related interstitial lung disease...
August 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28833985/switch-to-atovaquone-and-subsequent-re-challenge-with-trimethoprim-sulfamethoxazole-for-pneumocystis-prophylaxis-in-a-kidney-transplant-population
#17
Milena M McLaughlin, Audrey Galal, Chad L Richardson, Sarah H Sutton, Viktorija O Barr, Niketa Patel, Porntiwa Mitchell, Valentina Stosor
Kidney transplant recipients who are switched to atovaquone (ATO) from trimethoprim-sulfamethoxazole (TMP/SMX) for Pneumocystis jirovecii pneumonia (PJP) prophylaxis because of adverse events or complications may miss opportunities to be re-challenged with TMP/SMX, the first-line agent. This single-site, retrospective study assessed kidney transplant recipients for documented reasons for switching from TMP/SMX to alternate PJP prophylaxis and outcomes of TMP/SMX re-challenge. Out of 166 patients, 155 initially received TMP/SMX; of these, 31 were switched to ATO for various reasons...
August 21, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28803505/extracorporeal-membrane-oxygenation-in-an-hiv-positive-man-with-severe-acute-respiratory-distress-syndrome-secondary-to-pneumocystis-and-cytomegalovirus-pneumonia
#18
Deirdre Morley, Almida Lynam, Edmund Carton, Ignacio Martin-Loeches, Gerard Sheehan, Niamh Lynn, Serena O'Brien, Fiona Mulcahy
The management of critically ill human immunodeficiency virus (HIV)-positive patients is challenging; however, intensive care unit-related mortality has declined significantly in recent years. There are 10 case reports in the literature of extracorporeal membrane oxygenation (ECMO) use in HIV-positive patients, of whom seven survived to hospital discharge. We describe a 33-year-old Brazilian man who presented with Pneumocystis jirovecii pneumonia and severe hypoxic respiratory failure. He developed refractory acute respiratory distress syndrome (ARDS) and was commenced on veno-venous ECMO...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28793312/delays-in-hiv-diagnosis-and-associated-factors-among-patients-presenting-with-advanced-disease-at-a-tertiary-care-hospital-in-beijing-china
#19
Jing Xie, Evelyn Hsieh, Meng-Qing Sun, Huan-Ling Wang, Wei Lv, Hong-Wei Fan, Tai-Sheng Li
Delayed diagnosis of HIV infection is associated with advanced immunosuppression and increased risk of onward transmission. Little data exists regarding factors associated with diagnostic delays among patients presenting with advanced HIV disease in China. Medical records of patients with HIV/AIDS hospitalized at a 2000-bed tertiary hospital in Beijing, China between 1997 and 2012 were retrospectively reviewed. Demographic and clinical data of patients newly diagnosed with HIV at the hospital were abstracted...
2017: PloS One
https://www.readbyqxmd.com/read/28791509/feasibility-of-dose-dense-epirubicin-and-cyclophosphamide-with-subcutaneous-pegfilgrastim-3-6%C3%A2-mg-support-a-single-center-prospective-study-in-japan
#20
Sachi Morita, Toyone Kikumori, Nobuyuki Tsunoda, Takahiro Inaishi, Yayoi Adachi, Akiko Ota, Masahiro Shibata, Ayumu Matsuoka, Kenichi Nakanishi, Dai Takeuchi, Takefumi Mizutani, Tomoya Shimokata, Hironori Hayashi, Osamu Maeda, Yuichi Ando
BACKGROUND: Dose-dense chemotherapy consisting of a combination of epirubicin and cyclophosphamide (EC) improves the survival of patients with breast cancer. Although pegfilgrastim was used at a subcutaneous dose of 6.0 mg in a pivotal study of dose-dense EC treatment, pegfilgrastim at a dose of 3.6 mg has been approved in Japan. We have assessed the feasibility of dose-dense EC treatment supported with a 3.6 mg dose of pegfilgrastim by evaluating the relative dose intensity (RDI) and safety of the treatment, together with measuring the pegfilgrastim concentrations remaining on the day of starting the next cycle of chemotherapy...
August 8, 2017: International Journal of Clinical Oncology
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