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Pneumocystis Jirovecii

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https://www.readbyqxmd.com/read/29789160/pneumocystosis-and-quantitative-pcr
#1
N Issa, F Gabriel, G Baulier, G Mourissoux, I Accoceberry, O Guisset, F Camou
OBJECTIVE: Pneumocystis pneumonia (PCP) is now predominantly observed in immunosuppressed non-HIV-infected patients. The sensitivity of the PCR is here higher than direct examination (DE) of respiratory secretions because the infection is caused by a lower inoculum of Pneumocystis jirovecii (P. jirovecii). The objective of our retrospective study was to assess the contribution of quantitative PCR (qPCR) in the diagnosis of PCP. PATIENTS AND METHODS: All patients hospitalized for PCP suspicion with a positive qPCR were included...
May 19, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29779813/negative-role-of-malnutrition-in-cell-mediated-immune-response-pneumocystis-jirovecii-pneumonia-pcp-in-a-severely-malnourished-hiv-negative-patient-with-anorexia-nervosa
#2
Mouna Hanachi, Vanessa Bohem, Pauline Bemer, Nadja Kayser, Pierre de Truchis, Jean-Claude Melchior
It is generally acknowledged that malnutrition is a propensity factor for secondary infections in different clinical situations (malnutrition-associated infections in hospitalized patients and malnourished children in developing countries). However, it is not clear how malnutrition might facilitate the development of opportunistic infections in human immunodeficiency virus (HIV)-negative patients without a definite etiology (disease or treatment) of impaired cell-mediated immune response. We report here on a case of Pneumocystis jirovecii pneumonia in an HIV-negative patient suffering from anorexia nervosa with extreme malnutrition, which had a favorable outcome despite the severity of her respiratory failure...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29720434/evaluation-of-a-turbidimetric-%C3%AE-d-glucan-test-for-the-detection-of-pneumocystis-jirovecii-pneumonia
#3
Karl Dichtl, Ulrich Seybold, Johannes Wagener
Currently, diagnosis of Pneumocystis jirovecii pneumonia (PJP) relies on analysis of lower respiratory specimens, either by microscopy or qPCR. Thus, bronchoscopy is required, which is associated with increased risk of respiratory failure. We assessed the value of non-invasive serologic β-D-glucan (BDG) testing for laboratory diagnosis of PJP using a newly available turbidimetric assay. We identified 73 cases of PJP with positive qPCR results from lower respiratory specimens for Pneumocystis and serology samples dating from 1 week before to 4 weeks after qPCR...
May 2, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29704387/the-crucial-role-of-molecular-testing-to-facilitate-the-diagnosis-of-pneumocystis-pneumonia-during-pregnancy
#4
C H Ding, H Yusoff, N A S Muttaqillah, Y L Tang, T L Tan, P Periyasamy, A Y L Ban
Pneumocystis pneumonia is an important human immunodeficiency virus (HIV)-associated opportunistic infection, and especially so in pregnant HIV-positive patients. We report a case of a 40-year-old woman in her first trimester of pregnancy who initially presented with acute gastroenteritis symptoms but due to a history of high-risk behaviour and the observation of oral thrush, she was worked up for HIV infection. Her retroviral status was positive and her CD4+ T cell count was only 8 cells/µL. She was also worked up for pneumocystis pneumonia due to the presence of mild resting tachypnoea and a notable drop in oxygen saturation (from 100% to 88%) following brief ambulation...
April 2018: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/29691153/targeting-species-specific-amino-acid-residues-design-synthesis-and-biological-evaluation-of-6-substituted-pyrrolo-2-3-d-pyrimidines-as-dihydrofolate-reductase-inhibitors-and-potential-anti-opportunistic-infection-agents
#5
Khushbu Shah, Xin Lin, Sherry F Queener, Vivian Cody, Jim Pace, Aleem Gangjee
To combine the potency of trimetrexate (TMQ) or piritrexim (PTX) with the species selectivity of trimethoprim (TMP), target based design was carried out with the X-ray crystal structure of human dihydrofolate reductase (hDHFR) and the homology model of Pneumocystis jirovecii DHFR (pjDHFR). Using variation of amino acids such as Met33/Phe31 (in pjDHFR/hDHFR) that affect the binding of inhibitors due to their distinct positive or negative steric effect at the active binding site of the inhibitor, we designed a series of substituted-pyrrolo[2,3-d]pyrimidines...
April 17, 2018: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/29668131/-severe-hypoxemic-respiratory-failure-caused-by-pneumocystis-jirovecii-in-a-late-kidney-transplant-recipient
#6
John Fredy Nieto-Ríos, Mónica Zuluaga-Quintero, Arbey Aristizábal-Alzate, Catalina Ocampo-Kohn, Lina María Serna-Higuita, Isabel Cristina Ramírez-Sánchez, Gustavo Adolfo Zuluaga-Valencia
Pneumonia caused by Pneumocystis jirovecii is an uncommon infection in kidney transplant patients that can have an acute and rapid progression to respiratory failure and death. The period of greatest risk occurs in the first six months after the transplant, and it relates to the high doses of immunosuppression drugs required by patients. However, it may occur late, associated with the suspension of prophylaxis with trimethoprim-sulfamethoxazole.We present two cases of renal transplant patients who had severe hypoxemic respiratory failure due to P...
March 15, 2018: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/29666966/point-of-care-lung-ultrasound-for-diagnosis-of-pneumocystis-jirovecii-pneumonia-notes-from-the-field
#7
Maria Teresa Giordani, Francesca Tamarozzi, Daniel Kaminstein, Enrico Brunetti, Tom Heller
BACKGROUND: Thoracic ultrasound is helpful to evaluate lung pathology in patients with acute dyspnea. Several studies have demonstrated the efficacy of point-of-care ultrasound in patients with extrapulmonary TB and HIV co-infection. This retrospective, open-label case-control study explores the role of lung ultrasound in the diagnosis of Pneumocystis jirovecii pneumonia (PJP) in HIV-positive patients. In particular, it highlights the potential role of specific sonographic features that may be unique to this population...
April 17, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29664819/risk-factors-for-pneumocystis-jirovecii-pneumonia-in-patients-with-rheumatoid-arthritis-and-a-prophylactic-indication-of-trimethoprim-sulfamethoxazole
#8
Kazutoshi Yukawa, Yasutsugu Nagamoto, Hirofumi Watanabe, Masamoto Funaki, Mitsuhiro Iwahashi, Jiro Yamana, Rie Sasaki, Seizo Yamana
BACKGROUND/OBJECTIVES: Immunosuppressant medications (ISPs) increase the occurrence of Pneumocystis jirovecii pneumonia (PCP) in rheumatoid arthritis (RA) patients. The prophylactic administration of trimethoprim/sulfamethoxazole (TMP/SMX) for PCP is effective but has serious adverse effects and so should be selectively used for patients at high risk. The aims of this study were to clarify the risk factors for PCP in RA patients and to establish the indications for administering TMP/SMX...
April 17, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/29652202/effect-of-sulfasalazine-use-on-the-presence-of-pneumocystis-organisms-in-the-lung-among-patients-with-rheumatoid-arthritis-a-test-negative-design-case-control-study-with-pcr-tests
#9
Takahiro Nunokawa, Naoto Yokogawa, Kota Shimada, Shoji Sugii
OBJECTIVE: To evaluate the effect of sulfasalazine (SSZ) on the presence of Pneumocystis jirovecii (P. jirovecii) in the lungs of rheumatoid arthritis (RA) patients. METHODS: We retrospectively studied episodes of suspected P. jirovecii pneumonia (PJP) which were examined for P. jirovecii with polymerase chain reaction (PCR). We employed a test negative design case-control study; the cases were episodes of suspected PJP that were positive for PCR, and the controls were episodes of suspected PJP that were negative for PCR...
April 13, 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29629518/atypical-presentation-of-pneumocystis-jirovecii-infection-in-hiv-infected-patients-three-different-manifestations
#10
Bongyoung Kim, Jieun Kim, Seung Sam Paik, Hyunjoo Pai
Advances in the treatment and prevention of Pneumocystis jirovecii infection (PJI) in human immunodeficiency virus (HIV) patients decreased incidence and mortality dramatically, however, it may be associated with an increased frequency of unusual manifestation such as cystic formation, pneumothorax, focal infiltration, nodular formation, or extrapulmonary lesions. We report three cases of PJI with atypical manifestations. Each case demonstrates different clinical features: multiple nodular pulmonary lesion (32-year-old man with abnormal chest X-ray finding), subpleural mass-like lesion (43-year-old man with left visual loss and right pleuritic chest pain), and extrapulmonary mass-like lesions in the liver, lymph nodes, and small bowel (39-year-old man with cough, sputum, and dyspnea)...
April 9, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29622669/secular-trends-in-infection-related-mortality-after-kidney-transplantation
#11
Susanna Kinnunen, Pauli Karhapää, Auni Juutilainen, Patrik Finne, Ilkka Helanterä
BACKGROUND AND OBJECTIVES: Infections are the most common noncardiovascular causes of death after kidney transplantation. We analyzed the current infection-related mortality among kidney transplant recipients in a nationwide cohort in Finland. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Altogether, 3249 adult recipients of a first kidney transplant from 1990 to 2012 were included. Infectious causes of death were analyzed, and the mortality rates for infections were compared between two eras (1990-1999 and 2000-2012)...
April 5, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29620683/x-linked-severe-combined-immunodeficiency-and-hepatoblastoma-a-case-report-and-review-of-literature
#12
Sandra Diaz-Parra, Gema Lozano-Sanchez, Olga Escobosa-Sanchez, David Moreno-Perez, Antonio Morales-Martinez, Carolina Armengol-Niell, Tomás Acha-Garcia
Severe combined immunodeficiency is an inherited disease with profoundly defective T cells, B cells, and natural killer cells. X-linked severe combined immunodeficiency is the most common form. In this report, we describe a 4-month-old male infant who was admitted to our hospital with progressive breathlessness and abdominal mass. He was diagnosed with hepatoblastoma and presented a pneumocystis jirovecii pneumonia at the beginning of chemotherapy. Definitive diagnosis of X-linked severe combined immunodeficiency was established by DNA analysis of the interleukin 2 receptor gamma chain gene...
April 3, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29613974/fatal-p-jirovecii-and-cytomegalovirus-infections-in-an-infant-with-normal-trecs-count-pitfalls-of-newborn-screening-for-severe-combined-immunodeficiency
#13
Ana Mendez-Echevarria, Gonzalez-Granado Luis Ignacio, Luis M Allende, De Felipe Beatriz, Del Rosal Teresa, Calvo Cristina, Perez-Martinez Antonio, Ruiz Garcia Raquel, Neth Olaf
Newborn screening (NBS) for severe combined immunodeficiency (SCID) using T-cell receptor-excision circles (TRECs) allows prompt diagnosis and initiation of supportive and curative therapy thereby reducing morbidity and mortality. However, profound combined immunodeficiencies with normal numbers of non-functional T cells will go undetected. We present a patient with ORAI1 deficiency and normal TREC numbers observed after diagnosis at the age of 14 months who suffered from disseminated fatal cytomegalovirus and Pneumocystis jirovecii infection, demonstrating a potential pitfall of the current NBS program...
April 2, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29610164/-pneumocystis-jirovecii-pneumonia-during-sirolimus-therapy-for-kaposiform-hemangioendothelioma
#14
Thomas B Russell, Emily K Rinker, Claire S Dillingham, Laurence B Givner, Thomas W McLean
Sirolimus is an effective therapy for children with kaposiform hemangioendothelioma with or without the Kasabach-Merritt phenomenon. We report the case of a child with kaposiform hemangioendothelioma and the Kasabach-Merritt phenomenon who developed Pneumocystis carinii pneumonia (PCP) while on sirolimus and a prednisolone taper, after lack of adequate response to prednisolone, propranolol, and vincristine. He had a prompt positive clinical and laboratory response to sirolimus, but 4 weeks after starting it, at the age of 4 months, he developed PCP...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29574652/extracorporeal-life-support-for-immune-reconstitution-inflammatory-syndrome-in-hiv-patients-with-pneumocystis-jirovecii-pneumonia
#15
Kollengode Ramanathan, Julian K Svasti, Graeme MacLaren
Patients with immunosuppression from human immunodeficiency virus (HIV) have been traditionally considered poor candidates for extracorporeal membrane oxygenation (ECMO) because of high in-hospital mortality and poor long-term survival. Highly active antiretroviral therapy (HAART) has improved survival rates in compliant HIV patients and reversible severe respiratory failure may warrant ECMO in this group. Immune reconstitution inflammatory syndrome (IRIS) involves excessive inflammatory response to a pathogen with paradoxical clinical deterioration following HAART initiation and may present as severe respiratory failure...
March 24, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29562712/estimation-of-the-burden-of-serious-human-fungal-infections-in-malaysia
#16
Rukumani Devi Velayuthan, Chandramathi Samudi, Harvinder Kaur Lakhbeer Singh, Kee Peng Ng, Esaki M Shankar, David W Denning
Fungal infections (mycoses) are likely to occur more frequently as ever-increasingly sophisticated healthcare systems create greater risk factors. There is a paucity of systematic data on the incidence and prevalence of human fungal infections in Malaysia. We conducted a comprehensive study to estimate the burden of serious fungal infections in Malaysia. Our study showed that recurrent vaginal candidiasis (>4 episodes/year) was the most common of all cases with a diagnosis of candidiasis ( n = 501,138). Oesophageal candidiasis ( n = 5850) was most predominant among individuals with HIV infection...
March 19, 2018: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29562641/estimating-the-burden-of-serious-fungal-infections-in-uruguay
#17
Marina Macedo-Viñas, David W Denning
We aimed to estimate for the first time the burden of fungal infections in Uruguay. Data on population characteristics and underlying conditions were extracted from the National Statistics Institute, the World Bank, national registries, and published articles. When no data existed, risk populations were used to estimate frequencies extrapolating from the literature. Population structure (inhabitants): total 3,444,006; 73% adults; 35% women younger than 50 years. Size of populations at risk (total cases per year): HIV infected 12,000; acute myeloid leukemia 126; hematopoietic stem cell transplantation 30; solid organ transplants 134; COPD 272,006; asthma in adults 223,431; cystic fibrosis in adults 48; tuberculosis 613; lung cancer 1400...
March 18, 2018: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29553006/pneumocystis-jirovecii-exhalation-in-the-course-of-pneumocystis-pneumonia-treatment
#18
Laurence Pougnet, Anne Grall, Marie-Christine Moal, Richard Pougnet, Yohann Le Govic, Steven Négri, Gilles Nevez, Solène Le Gal
No abstract text is available yet for this article.
May 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29534652/the-impact-of-absolute-cd4-count-and-percentage-discordance-on-pneumocystis-jirovecii-pneumonia-prophylaxis-in-hiv-infected-patients
#19
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
https://www.readbyqxmd.com/read/29528776/venovenous-extracorporeal-life-support-in-patients-with-hiv-infection-and-pneumocystis-jirovecii-pneumonia
#20
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
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