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Pneumocystis jiroveci in childrens

Urszula Zaleska-Dorobisz, Cyprian Olchowy, Mateusz Łasecki, Dąbrówka Sokołowska-Dąbek, Aleksander Pawluś, Jowita Frączkiewicz, Ewa Gorczyńska
BACKGROUND: Management of febrile neutropenia in pediatric patients is challenging. Chest X-ray and CT scan help to identify infective foci; however, exposure to radiation is a risk factor for development of secondary cancer. For this reason, attention is paid to reducing radiation exposure. OBJECTIVES: The aim of the study was to define the role of LDCT examination in the early detection of pulmonary lesions in children during oncology or autoimmune treatment complicated by neutropenia-related fever...
July 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Parisa Badiee, Ali Rezapour, Amin Abbasian, Hamid Reza Foroutan, Hadis Jafarian
BACKGROUND AND OBJECTIVES: Pneumocystis jiroveci is an important causative agent of Pneumocystis pneumonia. During childhood, exposure to Pneumocystis occurs and antibody was built in early childhood. The aim of this study was to describe the molecular epidemiology of P. jiroveci in children without any respiratory syndrome and survey the distribution of different mitochondrial large subunit, ribosomal ribonucleic acid (mtLSU- rRNA) genotypes. MATERIALS AND METHODS: Mini-bronchoalveolar lavage (mini-BAL) fluids from pediatric patients with no history of lung disorders were obtained during a 14-month period...
October 2016: Iranian Journal of Microbiology
Laura Newberry, Bernadette O'Hare, Neil Kennedy, Andrew Selman, Sofia Omar, Pamela Dawson, Kim Stevenson, Yo Nishihara, Samantha Lissauer, Elizabeth Molyneux
BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) is the most common opportunistic infection in infants with vertically acquired HIV infection and the most common cause of death in HIV-infected infants. OBJECTIVES: To determine whether early administration of adjuvant corticosteroids in addition to standard treatment reduces mortality in infants with vertically acquired HIV and clinically diagnosed PJP when co-infection with cytomegalovirus and other pathogens cannot be excluded...
May 2017: Paediatrics and International Child Health
E R Samitova, T N Ermak, I E Koltunov, A N Kislyakov, N V Karazhas, T N Rybalkina, M Yu Kornienko
Pneumocystosis is well known as an opportunistic infection that is presently most frequently registered in patients with HIV infection and in those with other immunodeficiency states. Earlier, after the Second World War, Pneumocystis pneumonia was most commonly detected in debilitated and premature children; nosocomial outbreaks of pneumocystosis were studied in detail in the 1960s and 1970s. The pathogen is transmitted through the air, but a number of references indicate that it can be transmitted through the placenta...
2016: Terapevticheskiĭ Arkhiv
Heather E Machen, Zondiwe V Mwanza, Jocelyn K Brown, Kondwani M Kawaza, Laura Newberry, Rebecca R Richards-Kortum, Z Maria Oden, Elizabeth M Molyneux
OBJECTIVE: To describe the outcomes of infants and young children with respiratory distress when treated with a novel, low-cost, stand-alone bubble Continuous Positive Airway Pressure (bCPAP) system in a resource-limited setting. METHODS: A non-randomized, convenience sample study in a pediatric unit in Blantyre, Malawi, 2013. Patients weighing ≤10 kg with respiratory distress were eligible. We compared outcomes for patients with bronchiolitis, pneumonia and Pneumocystis jiroveci pneumonia (PJP) after treatment with bCPAP...
December 2015: Journal of Tropical Pediatrics
Aleksandra Szczawińska-Popłonyk, Katarzyna Jończyk-Potoczna, Lidia Ossowska, Anna Bręborowicz, Alicja Bartkowska-Śniatkowska, Jacek Wachowiak
Severe combined immunodeficiency (SCID) is characterized by the absence of functional T lymphocytes and impairment of adaptive immunity. While heterogeneity of the genetic background in SCID leads to the variability of immune phenotypes, most of affected newborns appear healthy but within the first few months they develop life-threatening opportunistic respiratory or gastrointestinal tract infections. The objective of the study was to define the presenting features and etiology of infections in children with SCID...
2014: Central-European Journal of Immunology
Birgit C P Koch, Sabina R Zabirova, Bart C H van der Nagel, Lidwien M Hanff
BACKGROUND: Sulfonamides in combination with trimethoprim are frequently used antibiotics. They work synergistic. In infections with Pneumocystis jiroveci or Stenotrophomonas maltophilia, higher dosages are indicated than in other infections. Therapeutic drug monitoring (TDM) is warranted to assure the efficacy while limiting toxicity. Although trimethoprim in combination with sulfamethoxazole is the most common combination with established TDM target concentrations, the intravenous formulation is not suited for children because of its additives ethanol and propylene glycol to increase solubility...
October 2015: Therapeutic Drug Monitoring
Bhunyabhadh Chaimay, Somkiattiyos Woradet, Sawanya Chantutanon, Supparaporn Phuntara, Kannika Suwanna
OBJECTIVE: The present study was to investigate clinical risk factors of survival among HIV-infected children born from HIV-infected mothers in the Southern region of Thailand. MATERIAL AND METHOD: Data from routine prospective cohort studies between 1990 and 2010 were analyzed In these studies, 1,549 HIV-infected children born to HIV-infected mothers were enrolled at birth and followed longitudinally. Information on demographic, clinical manifestations, and HIV-infection status factors was collected Survival analysis was used to determine risk factors associated with mortality...
November 2013: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Simon Lam, Fotini Dimitriou Kavadas, Seemab Haider, Mary Elizabeth Noseworthy
Severe combined immunodeficiency (SCID) is considered to be a pediatric emergency, with respiratory distress being the most common presenting symptom. The authors present two cases of SCID in children <4 months of age with respiratory distress at a tertiary care centre due to a recently described homozygous CD3 delta mutation found only in the Mexican Mennonite population. Failure to respond to broad-spectrum antibiotics prompted investigation for possible SCID. Bronchial alveolar lavage fluid from both patients grew Pneumocystis jiroveci, and flow cytometry revealed absent T cells...
January 2014: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Etan Orgel, Teresa Rushing
Cancer therapy routinely requires Pneumocystis jiroveci prophylaxis. In those intolerant of trimethoprim/sulfamethoxazole, aerosolized pentamidine is convenient and effective. Intravenous pentamidine is often substituted in young children but its efficacy remains controversial. In this retrospective study of a large pediatric oncology cohort, we confirm intravenous pentamidine to be effective and well-tolerated as second-line prophylaxis across all ages.
March 2014: Pediatric Infectious Disease Journal
Andrew Cant, Alexandra Battersby
Primary Immunodeficiencies (PIDs), although rare, are serious and heightened clinical suspicion leads to earlier diagnosis and improved outcome. Recognition of PIDs may be difficult as infections are common in young children in particular. Clues to the diagnosis of PID may be found in history, examination and initial basic investigations such as lymphocyte count. Age at presentation, type of infective organism and family history help focus on likely PIDs. Type of infective organism may indicate a specific PID, for example Aspergillus and Chronic Granulomatous Disease and Pneumocystis Jiroveci and SCID amongst others...
2013: Advances in Experimental Medicine and Biology
M Pilar Gambra, Teresa Bidart
Pneumocystis jiroveci is an important pathogen in patients undergoing SOT and HSCT. Universal prophylaxis is recommended for all adults and children with SOT and HSCT, considering that its use significantly reduces the occurrence and mortality associated with pneumonia by this agent. The drug of choice is cotrimoxazole (A1) three times a week, low-dose scheme, that has proved equally effective and better tolerated than the daily regimen and/or at high doses. Prophylaxis starts 7 to 14 days post transplant in SOT recipients and post-implant in HSCT, with an average duration of 6 months except in liver and lung transplant as in HSCT with significant degree of immunosuppression, that lasts for 1 year...
September 2012: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Carmen L Avilés, Pamela Silva, Marcela Zubieta, Ana M Alvarez, Ana Becker, Carmen Salgado, M Elena Santolaya, Santiago Topelberg, Juan Tordecilla, Mónica Varas, Milena Villarroel, Tamara Viviani
INTRODUCTION: Lung infections are a serious complication in children with cancer. Bronchoalveolar lavage (BAL) has been demonstrated to be an effective procedure for achieving etiologic diagnosis. METHOD: We did a retrospective analysis of BAL data performed between November 2005 and October 2008 in children with cancer, severe neutropenia and lung infiltrates for assessing its performance, clinical utility and safety. Thirty-seven BAL were evaluated in 35 patients...
June 2012: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Aditya H Gaur, Patricia M Flynn, Wally Bitar, Hua Liang
Current HIV guidelines recommend monitoring CD4 counts every 3-4 months. In the era of highly active antiretroviral therapy (HAART) and HIV PCR, this retrospective study reexamines the required frequency of the CD4 assay. Predictor variables, including age, previous CD4 count, HIV viral load (VL), time interval since last VL and CD4 count (TINT), and antiretroviral history, were abstracted. A recursive partitioning-based regression tree analysis was used to determine if the absolute current CD4 count was above or below the age appropriate Pneumocystis jiroveci pneumonia (PCP) prophylaxis cutoff...
March 2013: AIDS Research and Human Retroviruses
Mai Sato, Shuichi Ito, Masao Ogura, Koichi Kamei, Isao Miyairi, Ippei Miyata, Masataka Higuchi, Kentaro Matsuoka
BACKGROUND: Rituximab, an anti-CD20 antibody that targets B cells, is a promising agent against steroid-dependent and steroid-resistant nephrotic syndrome in children. CASE-DIAGNOSIS/TREATMENT: We report a 3-year-old boy who presented with atypical Pneumocystis jiroveci pneumonia (PCP) following administration of rituximab for refractory nephrotic syndrome. He had received cyclosporine and daily prednisolone for over 1 year. Following rituximab therapy, a hazy shadow was observed on his chest X-ray...
January 2013: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Omolemo P Kitchin, Refiloe Masekela, Piet Becker, Teshni Moodley, Sam M Risenga, Robin J Green
OBJECTIVE: Acute severe pneumonia with respiratory failure in human immunodeficiency virus-infected and -exposed infants carries a high mortality. Pneumocystis jiroveci is one cause, but other organisms have been suggested to play a role. Our objective is to describe the coinfections and treatment strategies in a cohort of human immunodeficiency virus-infected and -exposed infants with respiratory failure and acute respiratory distress syndrome, in an attempt to improve survival. DESIGN: Prospective intervention study...
September 2012: Pediatric Critical Care Medicine
T Sudjaritruk, P Oberdorfer, T Puthanakit, T Sirisanthana, V Sirisanthana
This study identified causes of first hospitalization among perinatally acquired HIV-infected children at Chiang Mai University Hospital between 1989 and 2009. Data were stratified into three seven-year time periods: pre-Pneumocystis jiroveci pneumonia (PJP) prophylaxis, pre-antiretroviral therapy (ART) and ART period. Over the 21-year study period, 1121 children were hospitalized. The mean age at admission was 2.7 years and had become older over time. Of the 1121 hospitalization causes, 50.6% were AIDS-defining illnesses (ADIs), 48...
May 2012: International Journal of STD & AIDS
Warunee Punpanich, Michelle Groome, Lulu Muhe, Shamim A Qazi, Shabir Ahmed Madhi
INTRODUCTION: Pneumonia is the leading cause of mortality in both human immunodeficiency virus (HIV)-infected and HIV-exposed children. Administration of appropriate empirical antimicrobial and/or adjunctive systemic therapies may improve clinical outcomes. METHODOLOGY: To identify effective antimicrobial and/or adjunctive systemic therapy for pneumonia in HIV-infected and HIV-exposed, uninfected children, we searched for published and unpublished studies from 11 databases including MedLine, Global Health Database, Biological Abstracts (BIOSIS), the Cochrane Central Register of Controlled Trials, the World Health Organization Library Information System, AIDSLine, and the System for Information on Grey Literature in Europe, along with additional four regional databases including African Index Medicus, Latin America and Caribbean, Eastern Mediterranean, and South-East Asian databases...
February 13, 2012: Journal of Infection in Developing Countries
Burke A Cunha, Uzma Syed, Jean E Hage
BACKGROUND: Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infections in young children, the elderly, and immunocompromised hosts, but RSV is a rare cause of community-acquired pneumonia (CAP) in hospitalized adults with human immunodeficiency virus (HIV). In patients with HIV, CAP is most frequently attributable to the usual bacterial respiratory pathogens that cause CAP in immunocompetent hosts, eg, Streptococcuspneumoniae or Hemophilus influenzae...
January 2012: Heart & Lung: the Journal of Critical Care
Jorge O Alarcón, Laura Freimanis-Hance, Margot Krauss, Mary F Reyes, Claudete Aparecida Araújo Cardoso, Marisa M Mussi-Pinhata, Edmundo Cardoso, Rohan Hazra
Opportunistic and other infections have declined since the introduction of highly active antiretroviral therapy (HAART) in developed countries but few studies have addressed the impact of HAART in HIV-infected children from developing countries. This study examines the prevalence and incidence of opportunistic and other infections in Latin America during the HAART era. Vertically HIV-infected children enrolled in a cohort study between 2002 and 2007 were followed for the occurrence of 29 targeted infections...
March 2012: AIDS Research and Human Retroviruses
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