scholarly journals Pneumocystis jirovecii pneumonia in a patient with HIV infection: complex diagnosis using Giemsa-stained bronchoalveolar lavage fluid

2021 ◽  
Vol 54 ◽  
Author(s):  
Louisy Sanches dos Santos ◽  
Lincoln de Oliveira Sant’Anna ◽  
Max Roberto Batista Araújo
Keyword(s):  
Hiv Infection ◽  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia

scholarly journals Detection of Pneumocystis jirovecii in Patients with Severe COVID-19: Diagnostic and Therapeutic Challenges

2021 ◽  
Vol 7 (8) ◽  
pp. 585
Author(s):  
Victor Gerber ◽  
Yvon Ruch ◽  
Thiên-Nga Chamaraux-Tran ◽  
Walid Oulehri ◽  
Francis Schneider ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Mechanical Ventilation ◽  
Hospital Admission ◽  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Tracheal Aspirate ◽  
Lavage Fluid ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Risk Patients

Cases of Pneumocystis jirovecii pneumonia (PCP) in patients suffering from COVID-19 were described in patients with various comorbidities and outcomes. The diagnosis of PCP in these patients is difficult due to clinical and radiological similarities. We carried out this study in order to better describe potentially at-risk patients and their outcomes. We retrospectively analyzed all patients with a P. jirovecii PCR performed in bronchoalveolar lavage fluid, tracheal aspirate, or sputum within a month after the COVID-19 diagnosis. Fifty-seven patients with COVID-19 infection were tested for P. jirovecii. Among 57 patients with COVID-19, four patients had a concomitant positive P. jirovecii PCR. These four patients were elderly with a mean age of 78. Two patients were immunocompromised, and the two others presented only diabetes mellitus. Three patients presented an ARDS requiring transfer to the ICU and mechanical ventilation. All patients presented lymphocytopenia. Three patients had probable PCP, and one had proven PCP. All patients died within two months after hospital admission. These co-infections are rare but severe, therefore, PCP should be considered in case of worsening of the condition of patients with severe COVID-19.

scholarly journals Diagnostic Performance of Bronchoalveolar Lavage (1,3)-β-d-Glucan Assay for Pneumocystis jirovecii Pneumonia

2020 ◽  
Vol 6 (4) ◽  
pp. 200
Author(s):  
Shiwei Zhou ◽  
Kathleen A. Linder ◽  
Carol A. Kauffman ◽  
Blair J. Richards ◽  
Steve Kleiboeker ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Test Performance ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Lavage Fluid ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Characteristic Area

We evaluated the performance of the (1,3)-β-d-glucan (BDG) assay on bronchoalveolar lavage fluid (BALF) as a possible aid to the diagnosis of Pneumocystis jirovecii pneumonia. BALF samples from 18 patients with well-characterized proven, probable, and possible Pneumocystis pneumonia and 18 well-matched controls were tested. We found that the best test performance was observed with a cut-off value of 128 pg/mL; receiver operating characteristic/area under the curve (ROC/AUC) was 0.70 (95% CI 0.52–0.87). Sensitivity and specificity were 78% and 56%, respectively; positive predictive value was 64%, and negative predictive value was 71%. The low specificity that we noted limits the utility of BALF BDG as a diagnostic tool for Pneumocystis pneumonia.

scholarly journals De Novo Assembly of the Pneumocystis jirovecii Genome from a Single Bronchoalveolar Lavage Fluid Specimen from a Patient

mBio ◽  
2012 ◽  
Vol 4 (1) ◽  
Author(s):  
Ousmane H. Cissé ◽  
Marco Pagni ◽  
Philippe M. Hauser
Keyword(s):  
Bronchoalveolar Lavage ◽  
Genome Sequence ◽  
Bronchoalveolar Lavage Fluid ◽  
De Novo ◽  
Gc Content ◽  
Lavage Fluid ◽  
New Drugs ◽  
Pneumocystis Jirovecii ◽  
Content Type

ABSTRACTPneumocystis jiroveciiis a fungus that causes severe pneumonia in immunocompromised patients. However, its study is hindered by the lack of anin vitroculture method. We report here the genome ofP. jiroveciithat was obtained from a single bronchoalveolar lavage fluid specimen from a patient. The major challenge was thein silicosorting of the reads from a mixture representing the different organisms of the lung microbiome. This genome lacks virulence factors and most amino acid biosynthesis enzymes and presents reduced GC content and size. Together with epidemiological observations, these features suggest thatP. jiroveciiis an obligate parasite specialized in the colonization of human lungs, which causes disease only in immune-deficient individuals. This genome sequence will boost research on this deadly pathogen.IMPORTANCEPneumocystispneumonia is a major cause of mortality in patients with impaired immune systems. The availability of theP. jiroveciigenome sequence allows new analyses to be performed which open avenues to solve critical issues for this deadly human disease. The most important ones are (i) identification of nutritional supplements for development of culturein vitro, which is still lacking 100 years after discovery of the pathogen; (ii) identification of new targets for development of new drugs, given the paucity of present treatments and emerging resistance; and (iii) identification of targets for development of vaccines.

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