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https://www.readbyqxmd.com/read/29225815/hypercalcaemia-preceding-diagnosis-of-pneumocystis-jirovecii-pneumonia-in-renal-transplant-recipients
#1
Jonathan Ling, Tara Anderson, Sanchia Warren, Geoffrey Kirkland, Matthew Jose, Richard Yu, Steven Yew, Samantha Mcfadyen, Alison Graver, William Johnson, Lisa Jeffs
Background: The overall incidence of Pneumocystis jirovecii pneumonia (PJP) in solid organ transplant recipients is 5-15%. A timely diagnosis of PJP is difficult and relies on imaging and detection of the organism. Methods: We present a case series of four patients displaying hypercalcaemia with an eventual diagnosis of PJP and document the management of the outbreak with a multidisciplinary team approach. We discuss the underlying pathophysiology and previous reports of hypercalcaemia preceding a diagnosis of PJP...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29211898/bilateral-upper-lobe-pneumocystis-pneumonia-during-aerosolized-pentamidine-prophylaxis
#2
Yoshiyuki Ohara, Takanori Asakura, Soichiro Ueda, Yoshitake Yamada, Makoto Ishii, Tomoko Betsuyaku
No abstract text is available yet for this article.
December 1, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29201630/avoidance-of-harm-from-treatment-for-anca-associated-vasculitis
#3
REVIEW
Catherine King, Lorraine Harper
Purpose of review With established immunosuppressant treatment regimens for anti-neutrophil cytoplasm antibody-associated vasculitides (AAV), prognosis has significantly improved. The mainstay of treatment still comprises high-dose corticosteroids and cyclophosphamide for severe forms, although rituximab is being increasingly utilised instead of cyclophosphamide as induction therapy. AAV patients experience an excess of infections, malignancies and cardiovascular events as compared to the general population, which is a combination of the systemic inflammatory process associated with vasculitis and the adverse events from treatment...
2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/29185961/recommendations-for-the-management-of-pulmonary-fungal-infections-in-patients-with-rheumatoid-arthritis
#4
REVIEW
Massimo Galli, Spinello Antinori, Fabiola Atzeni, Luca Meroni, Agostino Riva, Carlo Scirè, Fulvio Adorni, Luca Quartuccio, Marco Sebastiani, Paolo Airò, Laura Bazzichi, Francesco Cristini, Valerio Del Bono, Andreina Manfredi, Ombretta Viapiana, Francesco De Rosa, Ennio Favalli, Enzo Petrelli, Carlo Salvarani, Marcello Govoni, Silvia Corcione, Rossana Scrivo, Loredana Sarmati, Adriano Lazzarin, Walter Grassi, Claudio Mastroianni, Giovanni Battista Gaeta, Gianfranco Ferraccioli, Maurizio Cutolo, Salvatore De Vita, Giovanni Lapadula, Marco Matucci-Cerinic, Orlando Armignacco, Piercarlo Sarzi-Puttini
Often life-threatening pulmonary fungal infections (PFIs) can occur in patients with rheumatoid arthritis (RA) receiving disease-modifying anti-rheumatic drugs (DMARDs). Most of the data concerning PFIs in RA patients come from case reports and retrospective case series. Of the ve most widely described PFIs, Pneumocystis jirovecii pneumonia (PJP) has rarely been seen outside Japan, pulmonary cryptococcosis has been diagnosed in only a small number of patients worldwide, pulmonary coccidioidomycosis has almost only been observed in endemic areas, the limited number of cases of pulmonary histoplasmosis have mainly occurred in the USA, and the rare cases of invasive pulmonary aspergillosis have only been encountered in leukopenic patients...
November 28, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29092853/prophylactic-effect-of-trimethoprim-sulfamethoxazole-for-pneumocystis-pneumonia-in-patients-with-rheumatic-diseases-exposed-to-prolonged-high-dose-glucocorticoids
#5
Jun Won Park, Jeffrey R Curtis, Jinyoung Moon, Yeong Wook Song, Suhnggwon Kim, Eun Bong Lee
OBJECTIVES: To investigate the efficacy and safety of trimethoprim/sulfamethoxazole (TMP-SMX) as primary prophylaxis for pneumocystis pneumonia (PCP) in patients with rheumatic diseases receiving high-dose steroids. METHODS: The study included 1522 treatment episodes with prolonged (≥4 weeks) high-dose (≥30 mg/day prednisone) steroids in 1092 patients over a 12-year period. Of these, 262 treatment episodes involved TMP-SMX (prophylaxis group) while other episodes involved no prophylaxis (control group)...
November 1, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29079915/-pneumocystis-jirovecii-pneumonia-in-patients-with-autoimmune-diseases
#6
REVIEW
S Blaas
Pneumocystis jirovecii pneumonia plays an increasing role in patients with autoimmune disorders, due to more intensive immunosuppressive therapy. Humans seem to be the most important pathogen reservoir. Diseases are probably caused by airborne new infections. Cough, subfebrile temperature and dyspnea on exertion are the leading symptoms. In addition to imaging, in particular high-resolution computed tomography, pathogen detection by staining methods or molecular genetic methods plays the decisive role. Trimethoprim and sulfamethoxazole (TMP-SMX) is the most important medication for treatment...
November 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29039305/changing-epidemiology-of-pneumocystis-pneumonia-northern-ireland-uk-and-implications-for-prevention-1-july-2011-31-july-2012
#7
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/28992298/incidence-of-pneumocystis-jirovecii-and-adverse-events-associated-with-pneumocystis-prophylaxis-in-children-receiving-glucocorticoids
#8
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
#9
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
#10
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: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/28938676/risk-factors-for-mortality-from-pneumocystis-carinii-pneumonia-pcp-in-non-hiv-patients-a-meta-analysis
#11
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
#12
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
#13
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/28906322/the-effect-of-ophthalmic-artery-chemosurgery-on-immune-function-in-retinoblastoma-patients-a-single-institution-retrospective-analysis
#14
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...
October 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
#15
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
#16
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/28854309/determining-the-incidence-of-pneumocystis-pneumonia-in-patients-with-autoimmune-blistering-diseases-not-receiving-routine-prophylaxis
#17
MULTICENTER STUDY
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...
November 1, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28852481/infectious-complications-of-rituximab-therapy-in-renal-disease
#18
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/28843641/a-study-on-the-colonization-of-pneumocystis-jirovecii-among-outpatients-during-cancer-chemotherapy-and-among-healthy-smokers
#19
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/28833985/switch-to-atovaquone-and-subsequent-re-challenge-with-trimethoprim-sulfamethoxazole-for-pneumocystis-prophylaxis-in-a-kidney-transplant-population
#20
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
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