Read by QxMD icon Read

Pneumocystis Jirovecii

Henry Anyimadu, Chandra Pingili, Vel Sivapalan, Yael Hirsch-Moverman, Sharon Mannheimer
Current guidelines suggest that HIV-infected patients should receive chemoprophylaxis against Pneumocystis jirovecii pneumonia (PJP) if they have a cluster determinant 4 (CD4) count <200 cells/mm3 or oropharyngeal candidiasis. Persons with CD4 percentage (CD4%) below 14% should also be considered for prophylaxis. Discordance between CD4 count and CD4% occurs in 16% to 25% of HIV-infected patients. Provider compliance with current PJP prophylaxis guidelines when such discordance is present was assessed. Electronic medical records of 429 HIV-infected individuals who had CD4 count and CD4% measured at our clinic were reviewed...
January 2018: Journal of the International Association of Providers of AIDS Care
Gerry Capatos, Christopher R Burke, Mark T Ogino, Roberto R Lorusso, Thomas V Brogan, D Michael McMullan, Heidi J Dalton
AIM: As experience with extracorporeal life support (ECLS) increases, indications for its use have expanded to diverse patient populations, including those with HIV infection. Pneumocystis jirovecii pneumonia (PJP) is a particularly devastating complication of HIV infections. The objective of this study was to review ECLS use in HIV-positive patients, with particular emphasis on those with concomitant PJP infection. METHODS: All patients were treated by the same ECLS team, consisting of an ECLS specialist intensivist, cardiothoracic surgeon and allied medical professionals at three healthcare institutions...
March 1, 2018: Perfusion
Giacomo Veronese, Enrico Ammirati, Maria Cristina Moioli, Rossella Baldan, Carlo Andrea Orcese, Gisele De Rezende, Silvio Veronese, Gabriella Masciocco, Enrico Perna, Giovanna Travi, Massimo Puoti, Manlio Cipriani, Simon Tiberi, Daniela Cirillo, Maria Frigerio
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) outbreaks are described in solid organ transplant recipients. Few reports suggest interhuman transmission with important infection control implications. We described a large PJP outbreak in heart transplant (HTx) recipients. METHODS: Six cases of PJP occurred in HTx recipients within 10 months in our hospital. Demographics, clinical characteristics, treatment and outcomes were described. To identify contacts among individuals a review of all dates of out-patient visits and patient hospitalizations was performed...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Nathan Ford, Graeme Meintjes, Alexandra Calmy, Helen Bygrave, Chantal Migone, Marco Vitoria, Martina Penazzato, Lara Vojnov, Meg Doherty
In 2017, the World Health Organization (WHO) published guidelines for the management of advanced human immunodeficiency virus (HIV) disease within a public health approach. Recent data suggest that more than a third of people starting antiretroviral therapy (ART) do so with advanced HIV disease, and an increasing number of patients re-present to care at an advanced stage of HIV disease following a period of disengagement from care. These guidelines recommend a standardized package of care for adults, adolescents, and children, based on the leading causes of morbidity and mortality: tuberculosis, severe bacterial infections, cryptococcal meningitis, toxoplasmosis, and Pneumocystis jirovecii pneumonia...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
W A Werbel, M G Ison, M P Angarone, A Yang, V Stosor
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) affected 5-15% of solid organ transplant (SOT) recipients prior to universal prophylaxis, classically with trimethoprim-sulfamethoxazole (TMP-SMX). Guidelines generally recommend 6-12 months of prophylaxis post SOT, yet optimal duration and robust PJP risk stratification have not been established. METHODS: A retrospective, single-center, case-control study of PJP among SOT recipients from January 1998 to December 2013 was conducted...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Rita O Oladele, Akaninyene A Otu, Malcolm D Richardson, David W Denning
Globally, Pneumocystis pneumonia (PCP) remains a common and lethal infection in both HIV-positive and HIV-negative patients, particularly in developing countries where rates of PCP increases with rising GDP. Pneumocystis jirovecii cannot be cultured in routine clinical laboratories; thus diagnosis relies on microscopy, histology, serology and/or polymerase chain reaction (PCR) of the Pneumocystis DNA. Most of these methods are expensive and require training. Accessing lower respiratory tract specimens in young children is often challenging and only PCR testing of nasopharyngeal aspirates is useful...
2018: Journal of Health Care for the Poor and Underserved
Mengyan Wang, Biao Zhu
Pneumocystis jirovecii pneumonia is an opportunistic infection among immunocompromised people. Studies have found that the increased resistance to sulfa drugs of Pneumocystis jirovecii may be associated with the mutation of dihydropteroate synthase ( DHPS ) gene and dihydrofolate reductase ( DHFR ) genes, but the mechanism is still unclear. The mutation of DHPS and DHFR genes may be the result of sulfa drugs selection or spontaneous genetic polymorphism, and it can be acquired from person-to-person transmission...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Prithiv Prasad, Kevin Bryan Lo, Pradhum Ram
The highest risk of opportunistic infections is from 1 to 6 months post-transplant. We report a rare case of Pneumocystis jirovecii pneumonia in a renal transplant recipient only on maintenance immunosuppression eleven years after transplant without concomitant CMV infection or recent episodes of graft rejection.
June 2018: Medical Mycology Case Reports
T Baltazard, F Dhaille, S Duvert-Lehembre, C Lok, G Chaby
BACKGROUND: Linear IgA bullous dermatosis (LABD) is an autoimmune blistering skin disorder characterized by linear IgA deposits along the dermoepidermal junction. Usually idiopathic, LABD can be drug-induced. OBJECTIVE: To report the atypical characteristics of a case of trimethoprim-sulfamethoxazole-induced LABD presenting as toxic epidermal necrolysis (TEN). METHODS: A 63-year-old woman treated with trimethoprim-sulfamethoxazole for Pneumocystis jirovecii infection developed a generalized maculopapular rash with herpetiform lesions, rosette-like lesions, and tense bullae with Nikolsky sign...
August 15, 2017: Dermatology Online Journal
Ingvild Nordøy, Liv Hesstvedt, Cecilie Torp Andersen, Haima Mylvaganam, Nicola Isabelle Kols, Birgit Margrethe Falch, Ståle Tofteland, Fredrik Müller, David William Denning
The aim of this study was to examine the burden of fungal disease in Norway, contributing to a worldwide effort to improve awareness of the needs for better diagnosis and treatment of such infections. We used national registers and actual data from the Departments of Microbiology from 2015 and estimated the incidence and/or prevalence of superficial, allergic and invasive fungal disease using published reports on specific populations at risk. One in 6 Norwegians suffered from fungal disease: Superficial skin infections (14...
February 21, 2018: Journal of Fungi (Basel, Switzerland)
S Richard, J M G C F Almeida, O H Cissé, A Luraschi, O Nielsen, M Pagni, P M Hauser
Fungi of the genus Pneumocystis are obligate parasites that colonize mammals' lungs and are host species specific. Pneumocystis jirovecii and Pneumocystis carinii infect, respectively, humans and rats. They can turn into opportunistic pathogens in immunosuppressed hosts, causing severe pneumonia. Their cell cycle is poorly known, mainly because of the absence of an established method of culture in vitro It is thought to include both asexual and sexual phases. Comparative genomic analysis suggested that their mode of sexual reproduction is primary homothallism involving a single mating type ( MAT ) locus encompassing plus and minus genes ( matMc , matMi , and matPi ; Almeida et al...
February 20, 2018: MBio
Ahsan Wahab, Siddique Chaudhary, Mahin Khan, Susan Jane Smith
Concurrent Pneumocystis jirovecii (PJ) and pulmonary histoplasmosis (PHP) are rare in a single HIV individual. We present a challenging case of concomitant PJ and PHP in a young HIV individual. A 44-year-old man presented to the emergency department with progressive pulmonary symptoms. He was hypoxic with bilateral pulmonary opacities on chest radiograph. CT of the chest showed a geographical pattern of ground-glass attenuation. He started receiving intravenous antibiotics in addition to oral Bactrim for suspected PJ...
January 26, 2018: BMJ Case Reports
Felix Bongomin, Sara Gago, Rita O Oladele, David W Denning
Fungal diseases kill more than 1.5 million and affect over a billion people. However, they are still a neglected topic by public health authorities even though most deaths from fungal diseases are avoidable. Serious fungal infections occur as a consequence of other health problems including asthma, AIDS, cancer, organ transplantation and corticosteroid therapies. Early accurate diagnosis allows prompt antifungal therapy; however this is often delayed or unavailable leading to death, serious chronic illness or blindness...
October 18, 2017: Journal of Fungi (Basel, Switzerland)
E M Aliouat, E Dei-Cas, N Gantois, M Pottier, C Pinçon, S Hawser, A Lier, D B Huang
Pneumocystis pneumonia is a serious complication that may affect immunosuppressed patients. The absence of reliable and safe therapeutic alternatives to trimethoprim-sulfamethoxazole (TMP/SMX) justifies the search for more effective and less toxic agents. In this study, the in vitro and in vivo anti-Pneumocystis jirovecii activity of iclaprim, a diaminopyrimidine compound that exerts its antimicrobial activity through the inhibition of dihydrofolate reductase (DHFR), as does TMP, was evaluated alone or in combination with SMX...
January 12, 2018: European Journal of Clinical Microbiology & Infectious Diseases
L Qin, Z F Qiu, J Xie, T R Geng, J L Zhao, L Wan, T S Li
Objective: To investigate the common opportunistic infections and the characteristics of peripheral lymphocyte subsets in patients with systemic lupus erythematosus (SLE). Methods: From December 2013 to December 2016, peripheral lymphocyte subsets were consecutively detected by flow cytometry in treated SLE patients with or without opportunistic infections (OIs) . The lymphocyte subsets in healthy donors were used as normal control group. Results: A total of 145 treated SLE patients were enrolled including 108 with OIs and 37 without OIs...
January 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Ada Redondo-Benito, Adrian Curran, Ana Villar-Gomez, Ernesto Trallero-Araguas, Andreu Fernández-Codina, Iago Pinal-Fernandez, Jose Ángel Rodrigo-Pendás, Albert Selva-O'Callaghan
AIM: To describe the prevalence, clinical characteristics and risk factors of opportunistic infection (OI) in a cohort of patients with inflammatory myopathies, and compare mortality rates between those with and without OIs. METHODS: In total, 204 patients from our myositis cohort were reviewed to identify patients who had experienced an OI during the period 1986-2014. The patients' clinical characteristics, treatments received, and outcomes were systematically recorded...
February 2018: International Journal of Rheumatic Diseases
Hung Chang, Ming-Chung Kuo, Tung-Liang Lin, Jin-Hou Wu, Po-Nan Wang
The association of Pneumocystis jirovecii pneumonia (PJP) and acute myeloid leukaemia (AML) is not clearly defined. In our experience of 291 patients with AML, 20 (14 males and 6 females, median age 56) developed PJP (incidence 6.8%). Thirteen patients (65%) survived until discharge from hospital. We conclude that PJP is not uncommon among patients with AML. In clinical care of AML, awareness of PJP should be heightened and prophylaxis should be considered.
January 2018: Internal Medicine Journal
Shubhasree Banerjee, Ann Biehl, Maryam Ghaderi-Yeganeh, Zerai Manna, Sarfaraz Hasni
Background: Infection is common cause of morbidity and mortality in systemic lupus erythematosus (SLE). Our objective was to determine incidence and types of infections, particularly opportunistic infections, in SLE patients receiving cyclophosphamide, and to identify contribution of variables like demographics, steroid, other immunosuppressives, white blood cell and absolute neutrophil count to infection risk. Patients and Methods: We did retrospective chart review of SLE patients in our institute over last 10 years, who received minimum six cyclophosphamide infusions...
March 2017: Medical Research Archives
Marie-Françoise Rey, Charles Mary, Diane Sanguinetti, Stéphane Ranque, Christophe Bartoli, Coralie L'Ollivier
In both the post and pre combination antiretroviral therapy (cART) era, Pneumocystis jirovecii and Toxoplasma gondii remain common opportunistic infectious agents. The common manifestations are pneumonia for P. jirovecii and brain abscess for T. gondii. Nevertheless, co-infection remains rare, and pulmonary toxoplasmosis is scarce, or may be underestimated because of its similarity with Pneumocystis jirovecii pneumonia. We reported an uncommon case of an AIDS patient (6 CD4 + T cells/mm³) with both pulmonary and cerebral toxoplasmosis associated with pneumocystis pneumonia...
December 18, 2017: Diseases (Basel)
Magdalena Sokulska, Marta Kicia, Maria Wesolowska, Pawel Piesiak, Aneta Kowal, Maria Luísa Lobo, Zaneta Kopacz, Andrzej B Hendrich, Olga Matos
Pneumocystis jirovecii is an opportunistic fungus causing Pneumocystis pneumonia primarily in immunosuppressed patients. However, immunocompetent individuals may become colonized and, as asymptomatic carriers, serve as reservoirs of the pathogen. Moreover, these asymptomatic carriers are at higher risk of developing pneumonia if favorable conditions occur. This study aimed to determine the prevalence of P. jirovecii in patients with various pulmonary diseases and to characterize the genetic diversity of organisms circulating in the studied population...
December 8, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"