Diagnosis of pneumocystis pneumonia in a 2-year-old King Charles Cavalier Spaniel using the polymerase chain reaction

2018 ◽  
Vol 47 (1) ◽  
pp. 146-149 ◽  
Author(s):  
Ayeley A. K. Okine ◽  
Seth Chapman ◽  
Roger A. Hostutler ◽  
Robert Livingston
Keyword(s):  
Polymerase Chain Reaction ◽  
Pneumocystis Pneumonia ◽  
Chain Reaction ◽  
Polymerase Chain

Low Sensitivity of a Nested Polymerase Chain Reaction in Oropharyngeal Washings for the Diagnosis of Pneumocystis Pneumonia in HIV-Infected Patients

CHEST Journal ◽  
2005 ◽  
Vol 128 (1) ◽  
pp. 167-171 ◽  
Author(s):  
Kennedy Nyamande ◽  
Umesh G. Lalloo ◽  
Dennis York ◽  
Mogambal Naidoo ◽  
Elvis M. Irusen ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Pneumocystis Pneumonia ◽  
Chain Reaction ◽  
Nested Polymerase Chain Reaction ◽  
Polymerase Chain ◽  
Low Sensitivity

scholarly journals Clinical Performance of (1,3) Beta-D Glucan for the Diagnosis of Pneumocystis Pneumonia (PCP) in Cancer Patients Tested With PCP Polymerase Chain Reaction

2018 ◽  
Vol 69 (8) ◽  
pp. 1303-1309 ◽  
Author(s):  
Sejal Morjaria ◽  
John Frame ◽  
Alexandra Franco-Garcia ◽  
Alexander Geyer ◽  
Mini Kamboj ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Cancer Patients ◽  
Predictive Value ◽  
Clinical Performance ◽  
Reference Method ◽  
Pneumocystis Pneumonia ◽  
Clinical Syndrome ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
High Risk Cancer

Abstract Background Serum (1,3)-beta-D glucan (BDG) is increasingly used to guide the management of suspected Pneumocystis pneumonia (PCP). BDG lacks specificity for PCP, and its clinical performance in high-risk cancer patients has not been fully assessed. Polymerase chain reaction (PCR) for PCP detection is highly sensitive, but cannot differentiate between colonization and infection. We evaluated the diagnostic performance of serum BDG in conjunction with PCP PCR on respiratory samples in patients with cancer and unexplained lung infiltrates. Methods We performed a retrospective analysis of adult patients evaluated for PCP at our institution from 2012 to 2015, using serum BDG and PCP PCR. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the serum BDG at different thresholds were evaluated using PCP PCR alone or in conjunction with clinical presentation in PCP PCR–positive patients. Results With PCP PCR alone as the reference method, BDG (≥80 pg/mL) had a sensitivity of 69.8%, specificity of 81.2%, PPV of 34.6%, and NPV of 95.2% for PCP. At ≥200 pg/mL in patients with a positive PCR and a compatible PCP clinical syndrome, BDG had a sensitivity of 70%, specificity of 100%, PPV of 100%, and NPV of 52.0% for PCP. Conclusions Patients negative by both BDG and PCR were unlikely to have PCP. In patients with a compatible clinical syndrome for PCP, higher BDG values (>200 pg/mL) were consistently associated with clinically-significant PCP infections among PCP PCR–positive oncology patients.

Polymerase Chain Reaction for Diagnosing Pneumocystis Pneumonia in Non-HIV Immunocompromised Patients With Pulmonary Infiltrates

CHEST Journal ◽  
2009 ◽  
Vol 135 (3) ◽  
pp. 655-661 ◽  
Author(s):  
Élie Azoulay ◽  
Anne Bergeron ◽  
Sylvie Chevret ◽  
Nicolas Bele ◽  
Benoît Schlemmer ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Pneumocystis Pneumonia ◽  
Immunocompromised Patients ◽  
Chain Reaction ◽  
Pulmonary Infiltrates ◽  
Polymerase Chain

scholarly journals Incidence, clinical presentation, and outcomes of Pneumocystis pneumonia when utilizing Polymerase Chain Reaction-based diagnosis in patients with Hodgkin lymphoma

2020 ◽  
Vol 61 (11) ◽  
pp. 2622-2629
Author(s):  
Jason N. Barreto ◽  
Carrie A. Thompson ◽  
Patrick M. Wieruszewski ◽  
Amanda G. Pawlenty ◽  
Kristin C. Mara ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Hodgkin Lymphoma ◽  
Clinical Presentation ◽  
Pneumocystis Pneumonia ◽  
Chain Reaction ◽  
Polymerase Chain

scholarly journals Clinical Utilization of DiaSorin Molecular Polymerase Chain Reaction in Pneumocystis Pneumonia

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Gregory L Damhorst ◽  
Kari J Broder ◽  
Elizabeth C Overton ◽  
Ronelio Rara ◽  
Lindsay M Busch ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Clinical Decision Making ◽  
Area Under The Curve ◽  
Treatment Decision ◽  
Clinical Decision ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Chain Reaction ◽  
Significant Difference ◽  
Polymerase Chain

Abstract Background Pneumocystis jirovecii polymerase chain reaction (PCR) testing is a sensitive diagnostic tool but does not distinguish infection from colonization. Cycle threshold (CT) may correlate with fungal burden and could be considered in clinical decision making. Clinical use of PCR and significance of CT values have not previously been examined with the DiaSorin Molecular platform. Methods Retrospective review of P jirovecii PCR, CT values and clinical data from 18 months in a multihospital academic health system. The diagnostic performance of PCR with respect to pathology and correlation of CT with severity were examined. Results Ninety-nine of 1006 (9.8%) assays from 786 patients in 919 encounters were positive. Among 91 (9.9%) encounters in which P jirovecii pneumonia (PJP) was treated, 41 (45%) were influenced by positive PCR. Negative PCR influenced discontinuation of therapy in 35 cases. Sensitivity and specificity of PCR were 93% (95% CI, 68%–100%) and 94% (95% CI, 91%–96%) with respect to pathology. CT values from deep respiratory specimens were significantly different among treated patients (P = .04) and those with positive pathology results (P < .0001) compared to patients not treated and those with negative pathology, respectively, and was highly predictive of positive pathology results (area under the curve = 0.92). No significant difference was observed in comparisons based on indicators of disease severity. Conclusions Pneumocystis jirovecii PCR was a highly impactful tool in the diagnosis and management of PJP, and use of CT values may have value in the treatment decision process in select cases. Further investigation in a prospective manner is needed.

scholarly journals PositivePneumocystis jiroveciiSputum PCR Results with Negative Bronchoscopic PCR Results in Suspected Pneumocystis Pneumonia

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Kelly Pennington ◽  
John Wilson ◽  
Andrew H. Limper ◽  
Patricio Escalante
Keyword(s):  
Polymerase Chain Reaction ◽  
Chart Review ◽  
Time Frame ◽  
Pneumocystis Pneumonia ◽  
Negative Sample ◽  
Sample Collection ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Immunocompromised State ◽  
Tracheal Secretion

Introduction. The diagnostic standard forPneumocystis jiroveciipneumonia (PCP) is direct microscopic identification; however, in recent years, polymerase chain reaction (PCR) from bronchoalveolar lavage (BAL) samples to detectPneumocystisnucleic acids has proven to be more sensitive and specific. Sputum samples have been presumed inferior to bronchoscopic samples secondary to variability and adequacy of sample collection. We observed several cases of positive sputum PCP-PCR results with negative PCP-PCR BAL results. The aim of the current study was to further characterize the clinical setting and outcomes in patients with positive sputum PCP-PCR samples and negative BAL PCP-PCR samples.Methods. We identified all patients who underwentP. jirovecii-PCR testing at Mayo Clinic between 2011 and 2016. Patients with a positive sputum and negative BAL sample collected within a 14-day time frame were identified and underwent further chart review for demographics, immunocompromised state, and clinical outcome.Results. From 2011 to 2016, 4431 respiratory samples from 3021 unique patients were tested for the presence ofP. jiroveciiby PCR. Fifty-five samples (1.2% of all samples collected) belonging to 24 unique patients (0.79% of patients tested) were identified as having a positive and negative sample collected within 14 days. Of these 24 patients, 10 (46%) patients had a positive sputum or tracheal secretion sample with negative BAL or bronchial washings. Out of these 10 patients, 8 were immunocompromised and 9 underwent treatment for PCP with 6 patients improving.Conclusion. Our results suggest that discordantP. jirovecii-PCR testing results from sputum and bronchoscopic specimens are an infrequent occurrence. Patients with positiveP. jirovecii-PCR sputum/tracheal secretion samples and negative bronchoscopic samples appear to be clinically infected and respond to PCP treatment. SputumP. jirovecii-PCR testing may be a viable alternative to invasive testing.

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