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Pneumocystis Jirovecii

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https://www.readbyqxmd.com/read/29141926/ectopic-acth-syndrome-complicated-by-multiple-opportunistic-infections-treated-with-percutaneous-ablation-of-the-adrenal-glands
#1
Chrystal Chan, James Mark Roberts
Ectopic adrenocorticotropic hormone (ACTH)-related Cushing's syndrome can lead to multiple complications including severe immunosuppression. If the ACTH-secreting tumour cannot be found, definitive treatment is surgical adrenalectomy, typically followed by glucocorticoid replacement. Here, we present a case of fulminant respiratory failure secondary to coinfection with Pneumocystis jirovecii and cytomegalovirus in a patient with ectopic ACTH-dependent Cushing's syndrome with occult primary. Due to significant deconditioning, she was unable to undergo definitive adrenalectomy and instead underwent percutaneous microwave ablation of the adrenal glands...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29138020/moyamoya-syndrome-in-a-pediatric-patient-with-congenital-human-immunodeficiency-virus-type-1-infection-resulting-in-intracranial-hemorrhage
#2
Junko Yamanaka, Ikuma Nozaki, Mizue Tanaka, Hideko Uryuu, Noriko Sato, Takeji Matsushita, Hiroyuki Shichino
In the era of Antiretroviral Therapy (ART) in which human immunodeficiency virus type 1 (HIV-1) infection affected children can expect a better prognosis, the importance of careful follow up of pediatric HIV-1 cases for neurological complications has been growing. We present a case of hemorrhagic Moyamoya syndrome in a child with congenital HIV-1 infection. A 10-year-old girl was referred to our hospital for the treatment of Pneumocystis Jirovecii Pneumonia (PCP: Pneumocystis pneumonia). Her HIV-1 control was poor and Moyamoya syndrome was found during the opportunistic infection screening at admission...
November 11, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29136537/new-advances-in-understanding-the-host-immune-response-to-pneumocystis
#3
REVIEW
J Claire Hoving, Jay K Kolls
Pneumocystis jirovecii causes clinical pneumonia in immunocompromised hosts. Despite this, the inability to cultivate this organism in vitro has likely hindered the field in ascertaining the true impact of Pneumocystis in human infection. However the recent release of the genome as well as in advances in understanding host genetics, and other risk factors for infection and robust experimental models of disease have shed new light on the impact of this fungal pathogen as to better define populations at risk...
November 11, 2017: Current Opinion in Microbiology
https://www.readbyqxmd.com/read/29135400/-the-comparison-of-microscopy-and-real-time-polymerase-chain-reaction-methods-for-the-diagnosis-of-pneumocystis-jirovecii-pneumonia-evaluation-of-clinical-parameters
#4
Seray Töz, Cumhur Gündüz, Aslı Tetik, Meltem Taşbakan, Hüsnü Pullukçu, Feza Bacakoğlu, Mehmet Sezai Taşbakan, Figen Gülen, Ayşegül Ünver, Nevin Turgay
Introduction: Pneumocystis jirovecii pneumonia (PCP) causes serious infections, especially in patients with immunosuppressive diseases. In this study, it was aimed to evaluate the results of samples obtained from PCP suspected patients using two different methods together with clinical data. Materials and Methods: Microscopy and real time polymerase chain reaction (real time PCR) methods were performed with bronchoalveolar lavage (BAL) samples sended to Ege University Medical Faculty Direct Parasitology Diagnostic Laboratory between March 2009 and June 2010...
September 2017: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/29114024/mechanisms-of-surface-antigenic-variation-in-the-human-pathogenic-fungus-pneumocystis-jirovecii
#5
Emanuel Schmid-Siegert, Sophie Richard, Amanda Luraschi, Konrad Mühlethaler, Marco Pagni, Philippe M Hauser
Microbial pathogens commonly escape the human immune system by varying surface proteins. We investigated the mechanisms used for that purpose by Pneumocystis jirovecii This uncultivable fungus is an obligate pulmonary pathogen that in immunocompromised individuals causes pneumonia, a major life-threatening infection. Long-read PacBio sequencing was used to assemble a core of subtelomeres of a single P. jirovecii strain from a bronchoalveolar lavage fluid specimen from a single patient. A total of 113 genes encoding surface proteins were identified, including 28 pseudogenes...
November 7, 2017: MBio
https://www.readbyqxmd.com/read/29111605/influenza-and-pneumocystis-jirovecii-pneumonia-in-an-allogeneic-hematopoietic-stem-cell-transplantation-recipient-co-infection-or-superinfection
#6
Jacob Burke, Ayman O Soubani
Influenza infection and Pneumocystis jirovecii pneumonia (PJP) in hematopoietic stem cell transplant (HSCT) patients are well characterized, however no dual infections have been reported in this patient population and little evidence of mechanisms of interaction between the two infections exists. We present a 53-year-old male allogeneic HSCT patient on immunosuppressive therapy for the treatment of graft-versus-host disease initially diagnosed with influenza A H3, and later PJP. Despite the development of acute respiratory distress syndrome, the patient was successfully treated with appropriate antimicrobial therapy and aggressive supportive care...
November 7, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29090481/utility-of-flexible-bronchoscopy-with-polymerase-chain-reaction-in-the-diagnosis-and-management-of-pulmonary-infiltrates-in-allogeneic-hsct-patients
#7
Fei-Fei Tang, Xiao-Su Zhao, Lan-Ping Xu, Xiao-Hui Zhang, Yu-Hong Chen, Xiao-Dong Mo, Kai-Yan Liu, Xiao-Jun Huang
OBJECTIVES: Pulmonary infiltrates in allogeneic hematopoietic stem cell transplant (allo-HSCT) patients are potentially life-threatening and require early diagnosis and treatment. We aimed to retrospectively explore the clinical efficacy of polymerase chain reaction (PCR) in conjunction with flexible bronchoscopy (FB) in allo-HSCT patients with pulmonary infiltrates. PATIENTS AND METHODS: We retrospectively reviewed all patients undergoing FB after allo-HSCT at the Peking University Institute of Hematology from January 2013 to December 2016...
November 1, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29079915/-pneumocystis-jirovecii-pneumonia-in-patients-with-autoimmune-diseases
#8
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/29069759/diagnosis-of-pneumocystis-jirovecii-pneumonia-with-serum-cell-free-dna-in-non-hiv-infected-immunocompromised-patients
#9
Dong Wang, Yang Hu, Ting Li, Heng-Mo Rong, Zhao-Hui Tong
Conventional respiratory tract specimens, such as bronchoalveolar lavage (BAL) fluid and induced sputum for diagnosing Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients are difficult to obtain. Besides, bronchoscopy is an invasive procedure that carries the risk of causing rapidly progressive respiratory insufficiency. By contrast, serum cell-free DNA (cfDNA) is easy to obtain and has been proven useful in diagnosing cancer, pregnancy associated complications, parasite infection and sepsis...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/29054940/rare-presentation-of-an-old-bug
#10
Hasan Ahmad Hasan Albitar, Alice Gallo de Moraes, Kaiser G Lim
We highlight a rare presentation of Legionella infection in a 77-year-old woman with a clinical diagnosis of giant cell arteritis 2 months prior to presentation. She was started on 60 mg prednisone that was tapered to 10 mg after 4 weeks following her diagnosis. She presented with a 1-month progressive dyspnoea in the absence of any other symptoms. Her exposure history was significant only for a recent trip to Florida where she stayed at a hotel. Initial laboratory workup was significant for hyponatraemia (127 mmol/L)...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29039305/changing-epidemiology-of-pneumocystis-pneumonia-northern-ireland-uk-and-implications-for-prevention-1-july-2011-31-july-2012
#11
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/29033413/multiple-lung-cysts-due-to-pneumocystis-jirovecii-pneumonia
#12
Kazuaki Fukushima, Keishiro Yajima
No abstract text is available yet for this article.
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29030378/worsening-guillain-barr%C3%A3-syndrome-harbinger-of-iris-in-hiv
#13
Neeharika L Mathukumalli, Niloufer Ali, Meena A Kanikannan, Sireesha Yareeda
We report an HIV patient aged 38 years with acute inflammatory demyelinating polyradiculoneuropathy subtype of Guillain-Barré syndrome (GBS) as the only manifestation of seroconversion and worsening of GBS being the harbinger of immune reconstitution inflammatory syndrome (IRIS). To date, only 5 cases of GBS during IRIS are reported. They manifested either during the third week or later after starting highly active antiretroviral therapy (HAART). Our patient witnessed worsening weakness by fifth day after starting HAART, even before the occurrence of Pneumocystis jirovecii pneumonia, cautioning one of the impending serious complications of IRIS and helped us initiate steroids at an early date...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29029010/call-for-action-invasive-fungal-infections-associated-with-ibrutinib-and-other-small-molecule-kinase-inhibitors-targeting-immune-signaling-pathways
#14
Georgios Chamilos, Michail S Lionakis, Dimitrios P Kontoyiannis
Opportunistic infections caused by Pneumocystis jirovecii, Cryptococcus neoformans, and ubiquitous airborne filamentous fungi have been recently reported in patients with hematological cancers historically considered at low risk for invasive fungal infections (IFIs), after receipt of the Bruton tyrosine kinase inhibitor ibrutinib. The spectrum and severity of IFIs often observed in these patients implies the presence of a complex immunodeficiency that may not be solely attributed to mere inhibition of Bruton tyrosine kinase...
September 27, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28992298/incidence-of-pneumocystis-jirovecii-and-adverse-events-associated-with-pneumocystis-prophylaxis-in-children-receiving-glucocorticoids
#15
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/28979537/tension-pneumomediastinum-a-literal-form-of-chest-tightness
#16
David J Clancy, Andrew S Lane, Peter W Flynn, Ian M Seppelt
Tension pneumomediastinum is a rare and life-threatening complication of mediastinal emphysema which can occur with mechanical ventilation. We present a case of tension mediastinum associated with mechanical ventilation in a patient with Acute Respiratory Distress Syndrome due to Pneumocystis jirovecii pneumonia. We discuss the mechanism and pathophysiology of tension pneumomediastinum, the potential association with Pneumocystis jirovecii pneumonia and recruitment manouvres, and its definitive emergency treatment...
February 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28978595/hiv-related-pneumocystis-jirovecii-pneumonia-managed-with-caspofungin-and-veno-venous-extracorporeal-membrane-oxygenation-rescue-therapy
#17
Nathaniel Lee, David Lawrence, Brijesh Patel, Stephane Ledot
Patients with pneumocystis pneumonia have a risk of progressing to acute respiratory failure necessitating admission to intensive care. The case described is of a patient with a newly diagnosed HIV infection presenting with pneumocystis pneumonia. Despite initiating the appropriate pharmacological treatment the patient's clinical condition deteriorated, and required both rescue pharmacological therapy with echinocandins as well as respiratory support with extracorporeal membrane oxygenation therapy. The patient recovered well on ventilator and circulatory support despite a long weaning process complicated by sequelae common to pneumocystis pneumonia...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28948369/acute-hypoxemic-respiratory-failure-in-immunocompromised-patients-the-efraim-multinational-prospective-cohort-study
#18
Elie Azoulay, Peter Pickkers, Marcio Soares, Anders Perner, Jordi Rello, Philippe R Bauer, Andry van de Louw, Pleun Hemelaar, Virginie Lemiale, Fabio Silvio Taccone, Ignacio Martin Loeches, Tine Sylvest Meyhoff, Jorge Salluh, Peter Schellongowski, Katerina Rusinova, Nicolas Terzi, Sangeeta Mehta, Massimo Antonelli, Achille Kouatchet, Andreas Barratt-Due, Miia Valkonen, Precious Pearl Landburg, Fabrice Bruneel, Ramin Brandt Bukan, Frédéric Pène, Victoria Metaxa, Anne Sophie Moreau, Virginie Souppart, Gaston Burghi, Christophe Girault, Ulysses V A Silva, Luca Montini, François Barbier, Lene B Nielsen, Benjamin Gaborit, Djamel Mokart, Sylvie Chevret
BACKGROUND: In immunocompromised patients with acute hypoxemic respiratory failure (ARF), initial management aims primarily to avoid invasive mechanical ventilation (IMV). METHODS: To assess the impact of initial management on IMV and mortality rates, we performed a multinational observational prospective cohort study in 16 countries (68 centers). RESULTS: A total of 1611 patients were enrolled (hematological malignancies 51.9%, solid tumors 35...
September 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28945326/reliable-differentiation-of-pneumocystis-pneumonia-from-pneumocystis-colonization-by-quantification-of-major-surface-glycoprotein-gene-using-real-time-polymerase-chain-reaction
#19
Shivaprakash M Rudramurthy, Megha Sharma, Madhubala Sharma, Pankaj Rawat, Anup Ghosh, V Lakshmishree, Ritesh Aggarwal, Meenu Singh, Arunaloke Chakrabarti
BACKGROUND: A clear differentiation between pneumonia due to Pneumocystis jirovecii and 'colonization' is required for optimal case management. OBJECTIVE: A quantification of fungal burden using major surface glycoprotein (MSG) gene-based real-time PCR was undertaken for the same. METHODS: Lower respiratory tract samples collected from 104 patients of clinically suspected Pneumocystis pneumonia (PCP) were subjected to quantitative PCR using MSG gene...
September 25, 2017: Mycoses
https://www.readbyqxmd.com/read/28943270/investigation-of-nosocomial-pneumocystis-infections-usefulness-of-longitudinal-screening-of-epidemic-and-post-epidemic-pneumocystis-genotypes
#20
G Nevez, S Le Gal, N Noel, A Wynckel, A Huguenin, Y Le Govic, L Pougnet, M Virmaux, D Toubas, O Bajolet
BACKGROUND: Twenty-five patients, of whom 22 were renal transplant recipients, developed Pneumocystis jirovecii infections at the nephrology department of Reims University Hospital (France) from September 2008 to October 2009, whereas only four sporadic cases had been diagnosed in this department over the 14 previous years. AIM: This outbreak was investigated by analysing patient encounters and P. jirovecii types. METHODS: A transmission map was drawn up...
September 21, 2017: Journal of Hospital Infection
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