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Pneumocystis Jirovecii

Tobias Svensson, Kristina Lamberg Lundström, Martin Höglund, Honar Cherif
BACKGROUND: Patients treated for hematological malignancies have an increased risk of serious infections. Diagnosis and prompt initiation of therapy are essential. Bronchoalveolar lavage (BAL) is a well-established investigation for identifying the cause of pulmonary infiltrates in immunocompromised patients. The aim of the study was to determine the diagnostic yield of BAL in patients treated for hematological malignancies and how often it contributed to a modification of the anti-infectious therapy...
October 14, 2016: Upsala Journal of Medical Sciences
Kyung-Ran Kim, Jong Min Kim, Ji-Man Kang, Yae-Jean Kim
[This corrects the article on p. 252 in vol. 59, PMID: 27462353.].
September 2016: Korean Journal of Pediatrics
Jessica M Deckman, Cathryn J Kurkjian, Joseph P McGillis, Theodore J Cory, Susan E Birket, Linda M Schutzman, Brian S Murphy, Beth A Garvy, David J Feola
Recent studies show a substantial incidence of Pneumocystis jirovecii colonization and infection in patients with chronic inflammatory lung conditions. However, little is known about the impact of Pneumocystis upon the regulation of pulmonary immunity. We demonstrate here that Pneumocystis polarizes macrophages towards an alternatively activated macrophage-like phenotype. Genetically engineered mice that lack the ability to signal through IL-4 and IL-13 were used to show that Pneumocystis alternative macrophage activation is dependent upon signaling through these cytokines...
October 5, 2016: Immunobiology
Özge Mine Örenay, Funda Tamer, Evren Sarıfakıoğlu, Umran Yıldırım
No abstract text is available yet for this article.
September 2016: Acta Dermatovenerologica Alpina, Panonica, et Adriatica
Katarina Čurić, Mario Poljak, Alojz Ihan, Janez Tomažič
A small proportion of HIV-infected patients rapidly progress to AIDS; indeed, some individuals have been known to progress to AIDS within a year after primary infection. Pneumonia caused by Pneumocystis jirovecii (PCP) is the most frequent AIDS-defining illness. However, PCP can also rarely occur during primary HIV infection as a result of the severe immunosuppression that may accompany the early stage of HIV infection. Immune reconstitution inflammatory syndrome (IRIS) comprises two distinct syndromes: paradoxical IRIS and unmasking IRIS...
September 2016: Acta Dermatovenerologica Alpina, Panonica, et Adriatica
Anand Shah, Darius Armstrong-James
No abstract text is available yet for this article.
October 1, 2016: American Journal of Respiratory and Critical Care Medicine
Eri Watanabe, Hitoshi Sugawara, Takeshi Yamashita, Akira Ishii, Aya Oda, Chihiro Terai
We report the case of a 71-year-old Japanese woman with adult-onset Still's disease (AOSD) in whom macrophage activation syndrome (MAS) developed despite therapy with oral high-dose prednisolone and intravenous methylprednisolone pulse therapy twice. She was successfully treated with tocilizumab (TCZ). Soon afterward, her fever ceased and high levels of both ferritin and C-reactive protein levels decreased. Her course was complicated by disseminated intravascular coagulation, cytomegalovirus infection, and Pneumocystis jirovecii pneumonia...
2016: Case Reports in Medicine
Carlos Fritzsche, Hosam Ghanem, Sebastian Koball, Brigitte Mueller-Hilke, Emil C Reisinger
Haemodialysis patients have been found to have an increased risk of developing Pneumocystis pneumonia (PcP) compared to the control population. To the best of our knowledge, no data are available on pulmonary colonization with Pneumocystis jirovecii in haemodialysis patients; therefore, the aim of this study was to determine the prevalence of pulmonary colonization with P. jirovecii in haemodialysis patients, and to find the related risk factors. Induced sputa of 62 haemodialysis patients were investigated using quantitative polymerase chain reaction for the presence of P...
September 29, 2016: Infectious Diseases
Clara Valero, María José Buitrago, Maud Gits-Muselli, Marion Benazra, Aude Sturny-Leclère, Samia Hamane, Nicolas Guigue, Stéphane Bretagne, Alexandre Alanio
Pneumocystis jirovecii is an unculturable fungus and the causative agent of Pneumocystis pneumonia, a life-threatening opportunistic infection. Although molecular diagnosis is often based on the detection of mtLSU rRNA mitochondrial gene, the number of copies of mitochondrial genes had not been investigated. We developed and optimized six real-time PCR assays in order to determine the copy number of four mitochondrial genes (mtSSU rRNA, mtLSU rRNA, NAD1, and CYTB) in comparison to nuclear genome (DHPS and HSP70) and tested 84 bronchoalveolar fluids of patients at different stages of the infection...
2016: Frontiers in Microbiology
Theodore J Kottom, Deanne M Hebrink, Paige E Jenson, Jorge H Ramirez-Prado, Andrew H Limper
N-acetylglucosamine (GlcNAc), serves as an essential structural sugar on the cell surface of organisms. For example, GlcNAc is a major component of bacterial peptidoglycan, it is an important building block of fungal cell walls, including a major constituent of chitin and mannoproteins, and it also required for extracellular matrix generation by animal cells. Herein, we provide evidence for a uridine diphospho-N-acetylglucosamine (UDP-GlcNAc) pathway in Pneumocystis species. Using in silico search of the P...
September 15, 2016: American Journal of Respiratory Cell and Molecular Biology
Yuji Fujikura, Toshie Manabe, Akihiko Kawana, Shigeru Kohno
INTRODUCTION: The clinical benefits of adjunctive corticosteroids for Pneumocystis jirovecii (P. jirovecii) pneumonia in patients not infected with the human immunodeficiency virus (HIV) has not been evaluated by meta-analysis. METHODS: We conducted a systematic review of published studies describing the effects of adjunctive corticosteroids on outcome in non-HIV P. jirovecii pneumonia patients. Two investigators independently searched the PubMed and Cochrane databases for eligible articles written in English...
September 9, 2016: Archivos de Bronconeumología
Markus Unnewehr, Hendrik Friederichs, Patricia Bartsch, Bernhard Schaaf
BACKGROUND: To diagnose Pneumocystis jirovecii pneumonia (PCP), PCR testing in bronchoalveolar lavage (BAL) fluid has recently become an alternative to immunofluorescence testing (IFT); however, its diagnostic accuracy is less clear. OBJECTIVE: To analyze the diagnostic value of a new semiquantitative real-time PCR (RT-PCR) in BAL in a real-life clinical setting. METHODS: Retrospective analysis of all RT-PCR results [semiquantitative: negative, weakly positive, and strongly positive; measured in cycle thresholds (Ct)] in BAL in the period between 2010 and 2014...
2016: Respiration; International Review of Thoracic Diseases
Guillaume Desoubeaux, Claire Franck-Martel, Agnès Caille, Nicolas Drillaud, Marie-Alix Lestrade Carluer de Kyvon, Éric Bailly, Jacques Chandenier
The biological diagnosis of Pneumocystis jirovecii pneumonia (PjP) is based on the investigation of respiratory fluids by conventional staining methods and/or molecular biology. Diagnostic performance of an in-house technique based on calcofluor-blue brightener for the direct detection of P. jirovecii cysts was prospectively assessed in bronchial-alveolar lavage fluids (BALF) from patients with a suspected PjP infection over a three-year period in a single center: the diagnostic yield was compared to that of a commercial kit based on monoclonal immunofluorescence assay (IFA) on replicate smears...
August 25, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Georg Maschmeyer, Jannik Helweg-Larsen, Livio Pagano, Christine Robin, Catherine Cordonnier, Peter Schellongowski
The initiation of systemic antimicrobial treatment of Pneumocystis jirovecii pneumonia (PCP) is triggered by clinical signs and symptoms, typical radiological and occasionally laboratory findings in patients at risk of this infection. Diagnostic proof by bronchoalveolar lavage should not delay the start of treatment. Most patients with haematological malignancies present with a severe PCP; therefore, antimicrobial therapy should be started intravenously. High-dose trimethoprim/sulfamethoxazole is the treatment of choice...
September 2016: Journal of Antimicrobial Chemotherapy
Johan Maertens, Simone Cesaro, Georg Maschmeyer, Hermann Einsele, J Peter Donnelly, Alexandre Alanio, Philippe M Hauser, Katrien Lagrou, Willem J G Melchers, Jannik Helweg-Larsen, Olga Matos, Stéphane Bretagne, Catherine Cordonnier
The 5th European Conference on Infections in Leukaemia (ECIL-5) meeting aimed to establish evidence-based recommendations for the prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in non-HIV-infected patients with an underlying haematological condition, including allogeneic HSCT recipients. Recommendations were based on the grading system of the IDSA. Trimethoprim/sulfamethoxazole given 2-3 times weekly is the drug of choice for the primary prophylaxis of PCP in adults ( A-II: ) and children ( A-I: ) and should be given during the entire period at risk...
September 2016: Journal of Antimicrobial Chemotherapy
Alexandre Alanio, Philippe M Hauser, Katrien Lagrou, Willem J G Melchers, Jannik Helweg-Larsen, Olga Matos, Simone Cesaro, Georg Maschmeyer, Hermann Einsele, J Peter Donnelly, Catherine Cordonnier, Johan Maertens, Stéphane Bretagne
The Fifth European Conference on Infections in Leukaemia (ECIL-5) convened a meeting to establish evidence-based recommendations for using tests to diagnose Pneumocystis jirovecii pneumonia (PCP) in adult patients with haematological malignancies. Immunofluorescence assays are recommended as the most sensitive microscopic method (recommendation A-II: ). Real-time PCR is recommended for the routine diagnosis of PCP ( A-II: ). Bronchoalveolar lavage (BAL) fluid is recommended as the best specimen as it yields good negative predictive value ( A-II: )...
September 2016: Journal of Antimicrobial Chemotherapy
Catherine Cordonnier, Simone Cesaro, Georg Maschmeyer, Hermann Einsele, J Peter Donnelly, Alexandre Alanio, Philippe M Hauser, Katrien Lagrou, Willem J G Melchers, Jannik Helweg-Larsen, Olga Matos, Stéphane Bretagne, Johan Maertens
Pneumocystis jirovecii can cause life-threatening pneumonia following treatment for haematological malignancies or after HSCT. The mortality rate of P. jirovecii pneumonia (PCP) in these patients is 30%-60%, especially after HSCT. The clinical presentation of PCP in haematology differs from that associated with HIV infection, with the disease being acute and more often severe, having a lower fungal burden and being more frequently linked to treatment with corticosteroids. Most cases occur in patients not receiving adequate prophylaxis...
September 2016: Journal of Antimicrobial Chemotherapy
Soykan Ozkoc, Murat Koker, Mustafa Onder, Songul Bayram Delibas
Detection of Pneumocystis jirovecii (P. jirovecii) and its DNA in clinically asymptomatic people is defined as colonization. The aim of this study was to reveal the colonization prevalence of P. jirovecii and affecting factors in an immunocompetent population. The study included 200 cases undergoing forensic autopsy between February 2015 and April 2015. The cause of death was non-medical conditions (group 1) in 111 cases (55.5%), medical conditions (group 2) in 73 cases (36.5%) and was undetermined (group 3) in 16 cases (group 3)...
August 19, 2016: Journal of Medical Microbiology
Inhye E Ahn, Theresa Jerussi, Mohammed Farooqui, Xin Tian, Adrian Wiestner, Juan Gea-Banacloche
Ibrutinib is not known to confer risk for Pneumocystis jirovecii pneumonia (PCP). We observed 5 cases of PCP in 96 patients receiving single-agent ibrutinib, including 4 previously untreated. Clinical presentations included asymptomatic pulmonary infiltrates, chronic cough, and shortness of breath. The diagnosis was often delayed. Median time from starting ibrutinib to occurrence of PCP was 6 months (range, 2-24). The estimated incidence of PCP was 2.05 cases per 100 patient-years (95% confidence interval, 0...
October 13, 2016: Blood
Solène Le Gal, Florence Robert-Gangneux, Yann Pépino, Sorya Belaz, Céline Damiani, Paul Guéguen, Mélanie Pitous, Michèle Virmaux, Eloise Lissillour, Laurence Pougnet, Thibaud Guillaud-Saumur, Dominique Toubas, Stéphane Valot, Christophe Hennequin, Florent Morio, Lilia Hasseine, Jean-Philippe Bouchara, Anne Totet, Gilles Nevez
This article describes a previously unreported mutation at position 210 (C210T) of the mitochondrial large subunit ribosomal RNA (mtLSUrRNA) gene of Pneumocystis jirovecii, which led to a false-negative result of a real-time polymerase chain reaction (PCR) assay. Since the aforementioned real-time PCR assay is widely used in France, a French multicenter study was conducted to estimate the mutation frequency and its potential impact on the routine diagnosis of Pneumocystis pneumonia (PCP). Through analysis of data obtained from eight centers, the mutation frequency was estimated at 0...
August 3, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
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