Pneumocystis pneumonia
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Overview
Pneumocystis pneumonia (PCP) is a form of pneumonia caused by the yeast-like fungal Pneumocystis jirovecii (Jirovecii is pronounced "yee row vet zee eye"). The causal agent was originally described as a protozoan and spelled P. jiroveci and prior to then was classified as a form of Pneumocystis carinii, a name still in common usage.[1][2] These names are discussed below. As a result, Pneumocystis pneumonia (PCP) has also been known as Pneumocystis jiroveci[i] pneumonia and as Pneumocystis carinii pneumonia, as is also explained below.[3][4][5]
It is relatively rare in people with normal immune systems but common among people with weakened immune systems, such as premature or severely malnourished children, the elderly, and especially AIDS patients, in whom it is most commonly observed today.[6] PCP can also develop in patients who are taking immunosuppressant medications (e.g. patients who have undergone solid organ transplantation) and in patients who have undergone bone marrow transplantation.
The organism is distributed worldwide[7][2].
Epidemiology
Symptoms
Pathophysiology
Diagnosis
The diagnosis can be definitively confirmed by pathologic identification of the causative organism in induced sputum or bronchial washings obtained by bronchoscopy with coloration by toluidine blue or immunofluorescence assay, which will show characteristic cysts [3].
Pneumocystis infection can also be diagnosed by immunofluorescent or histochemical staining of the specimen, and more recently by molecular analysis of PCR products comparing DNA samples. Notably, simple molecular detection of Pneumocystis jirovecii in lung fluids does not mean that a person has Pneumocystis pneumonia or infection by HIV. The fungus appears to be present in healthy individuals also in the general population.[8]
Life-cycle
Treatment
Guidelines
To read about guidelines for prevention and treatment of Pneumocystis pneumonia Infections in HIV-Infected Adults and Adolescents, click here.
References
- ↑ Stringer JR, Beard CB, Miller RF, Wakefield AE (2002). "A new name (Pneumocystis jiroveci) for Pneumocystis from humans". Emerg Infect Dis. 8 (9): 891–6. PMID 12194762.
- ↑ Redhead SA, Cushion MT, Frenkel JK, Stringer JR (2006). "Pneumocystis and Trypanosoma cruzi: nomenclature and typifications". J Eukaryot Microbiol. 53 (1): 2–11. PMID 16441572.
- ↑ Cushion MT . (1998). "Chapter 34. Pneumocystis carinii. In: Collier, L., Balows, A. & Sussman, M. (ed.), Topley and Wilson's Microbiology and Microbial Infections 9th ed. Arnold and Oxford Press, New York": 645–683.
- ↑ Cushion MT (1998). "Taxonomy, genetic organization, and life cycle of Pneumocystis carinii". Semin. Respir. Infect. 13 (4): 304–312.
- ↑ Cushion MT (2004). "Pneumocystis: unraveling the cloak of obscurity". Trends Microbiol. 12 (5): 243–249.
- ↑ Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0838585299.
- ↑ Morris A; et al. (2004). "Current Epidemiology of Pneumocystis Pneumonia". Emerg Infect Dis. 10 (10): 1713–1720. PMID 15504255.
- ↑ Medrano FJ; et al. (2005). "Pneumocystis jirovecii in General Population". Emerg Infect Dis. 11 (2): 245–250. PMID 15752442.