Septic Shock Due To Pneumocystis Pneumonia In HIV Infected Patients- Is The Virulence Of Pneumocystis Jiroveci Changing?

10.5580/2ca7 ◽  
2012 ◽  
Vol 13 (1) ◽  
Keyword(s):  
Septic Shock ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jiroveci

Intrauterine Pneumocystis infection

2016 ◽  
Vol 88 (11) ◽  
pp. 99-102
Author(s):  
E R Samitova ◽  
T N Ermak ◽  
I E Koltunov ◽  
A N Kislyakov ◽  
N V Karazhas ◽  
...  
Keyword(s):  
Intrauterine Infection ◽  
Pneumocystis Pneumonia ◽  
In Utero ◽  
Pneumocystis Jiroveci ◽  
1960S And 1970S ◽  
Pneumocystis Infection ◽  
The 1960S ◽  
Number Of Publications ◽  
Child's Death ◽  
Second World

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. Despite the increasing number of publications on pneumocystosis in pediatrics, physicians remain unfamiliar with this disease. The paper provides evidence that Pneumocystis jiroveci can infect the fetus in utero. If unrecognized, the disease can lead to a child’s death due to severe respiratory failure. The authors describe their case of generalized pneumocystosis that has developed in a child with evidence of intrauterine infection (detection of the pathogen in the autopsy material and placenta and identification of serological markers in his/her parents). The issues that are associated with intrafamilial infection and a risk for in utero transmission of P. jiroveci are discussed.

Molecular epidemiology of Pneumocystis jiroveci in human immunodeficiency virus-positive and -negative immunocompromised patients in The Netherlands

2014 ◽  
Vol 63 (10) ◽  
pp. 1294-1302 ◽  
Author(s):  
Marijke J. Vanspauwen ◽  
Vera E. J. Knops ◽  
Cathrien A. Bruggeman ◽  
Walther N. K. A. van Mook ◽  
Catharina F. M. Linssen
Keyword(s):  
The Netherlands ◽  
Clinical Relevance ◽  
Lavage Fluid ◽  
Underlying Disease ◽  
Pneumocystis Pneumonia ◽  
Surface Glycoprotein ◽  
Immunocompromised Patients ◽  
Pneumocystis Jiroveci ◽  
Major Surface ◽  
Pcr Targeting

Pneumocystis jiroveci infections can cause pneumocystis pneumonia (PCP) or lead to colonization without signs of PCP. Over the years, different genotypes of P. jiroveci have been discovered. Genomic typing of P. jiroveci in different subpopulations can contribute to unravelling the pathogenesis, transmission and spread of the different genotypes. In this study, we wanted to determine the distribution of P. jiroveci genotypes in immunocompetent and immunocompromised patients in The Netherlands and determine the clinical relevance of these detected mutations. A real-time PCR targeting the major surface glycoprotein gene (MSG) was used as a screening test for the presence of P. jiroveci DNA. Samples positive for MSG were genotyped based on the internal transcribed spacer (ITS) and dihydropteroate synthase (DHPS) genes. Of the 595 included bronchoalveolar lavage fluid samples, 116 revealed the presence of P. jiroveci DNA. A total of 52 of the 116 samples were ITS genotyped and 58 DHPS genotyped. The ITS genotyping revealed 17 ITS types, including two types that have not been described previously. There was no correlation between ITS genotype and underlying disease. All ITS- and DHPS-genotyped samples were found in immunocompromised patients. Of the 58 DHPS-genotyped samples, 50 were found to be WT. The other eight samples revealed a mixed genotype consisting of WT and type 1. The majority of the latter recovered on trimethoprim–sulfamethoxazole suggesting no clinical relevance for this mutation.

Evidence of Pneumocystis jiroveci in human clinical samples in southwestern Slovakia over a 10-year period (2001–2010)

Biologia ◽  
2013 ◽  
Vol 68 (4) ◽  
Author(s):  
Vojtech Boldiš ◽  
František Ondriska ◽  
Ľubor Kováč ◽  
Eva Nohýnková ◽  
Eva Špitalská
Keyword(s):  
Lupus Erythematosus ◽  
Opportunistic Pathogen ◽  
Pneumocystis Pneumonia ◽  
Pulmonary Complications ◽  
Clinical Samples ◽  
Pneumocystis Jiroveci ◽  
Risk Of Death ◽  
Effective Diagnosis ◽  
Lung Biopsies ◽  
Tract Infections

AbstractIn the past, Pneumocystis jiroveci (formerly P. carinii) belonged to the Protozoa group, but the studies on structure of the cell wall and nucleotide sequence resulted in the reclassification of this organism in the kingdom Fungi. P. jiroveci is an opportunistic pathogen, responsible for pneumocystis pneumonia with frequent complications of immunocompromised patients. Delayed initiation of appropriate therapy increases the risk of death in immunocompromised patient. The aim of this work was to determine the prevalence of P. jiroveci from patients suspected of having respiratory tract infections in southwestern Slovakia over a 10-year period. Due to the increasing number of immunosuppressed persons, the diagnostic of P. jiroveci in patients with pulmonary complications is essential to improve recovery onsets. Effective diagnosis is currently based on microscopic examination and detection of parasite DNA by polymerase chain reaction (PCR) in bronchoalveolar lavage (BAL) and induced sputum. In total, 386 clinical samples originated from patients suspected of pneumocystis infection were tested within ten years. Requirements for diagnosis of the pathogen were growing during the period. Three hundred and sixteen BALs, 59 induced sputa, 10 lung biopsies and 1 liquor were subjected to the detection of P. jiroveci. P. jiroveci DNA was detected in 30 patients using PCR, but cysts of microorganism were present only in 4 cases by microscopy. The pathogen was confirmed in 24 BALs and 6 sputa samples. The presence of P. jiroveci has been demonstrated mainly in immunocompromised individuals with cancer (20), but also in patients with pneumonia (6+1 HIV), with unspecified parasitic diseases (1+1HIV) and with systemic lupus erythematosus (1).

Small-Intestine Pneumocystis jiroveci Pseudotumor as an Acquired Immunodeficiency Syndrome–Presenting Illness: Report of a Case and Review of the Literature

2012 ◽  
Vol 136 (9) ◽  
pp. 1001-1003 ◽  
Author(s):  
Yi Zhou ◽  
Jayarama Shetty ◽  
Michael R Pins
Keyword(s):  
Small Intestine ◽  
Acquired Immunodeficiency Syndrome ◽  
Pneumocystis Pneumonia ◽  
Review Of The Literature ◽  
Pneumocystis Jiroveci ◽  
Immunodeficiency Virus ◽  
Acquired Immunodeficiency ◽  
Pneumocystis Infection ◽  
Immunodeficiency Syndrome ◽  
Associated Mass

A Pneumocystis jiroveci infection–associated mass clinically mimicking a malignancy (ie, pseudotumor) is rare and usually occurs in the lung in association with Pneumocystis pneumonia. Pneumocystis jiroveci pseudotumors of the small intestine are extremely rare and represent an unusual form of disseminated P jiroveci infection. We present a case of small-intestine P jiroveci pseudotumor as an acquired immunodeficiency syndrome–presenting illness in a patient with coinfection with cytomegalovirus, no pulmonary symptoms, and no known risk factors for human immunodeficiency virus infection. This case reinforces the potential importance of cytomegalovirus coinfection in the disseminated form of Pneumocystis infection and illustrates the importance of an expanded differential diagnosis when confronted with a clinically atypical mass lesion.

scholarly journals A Fatal Case of Concurrent Disseminated Tuberculosis, Pneumocystis Pneumonia, and Bacterial Septic Shock in a Patient with Rheumatoid Arthritis Receiving Methotrexate, Glucocorticoid, and Tocilizumab: An Autopsy Report

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Shin-Ichiro Ohmura ◽  
Ryuhei Ishihara ◽  
Ayaka Mitsui ◽  
Yoshiro Otsuki ◽  
Toshiaki Miyamoto
Keyword(s):  
Rheumatoid Arthritis ◽  
Escherichia Coli ◽  
Septic Shock ◽  
Respiratory Failure ◽  
Causes Of Death ◽  
Opportunistic Infections ◽  
Fatal Case ◽  
Pneumocystis Pneumonia ◽  
Disseminated Tuberculosis ◽  
Autopsy Report

Recently, treatment for rheumatoid arthritis has dramatically improved but increases the risk of bacterial and opportunistic infections. Herein, we report a fatal case of concurrent disseminated tuberculosis, pneumocystis pneumonia, and septic shock due to pyelonephritis caused by extended-spectrum β-lactamase-producing Escherichia coli in a patient with rheumatoid arthritis who received methotrexate, glucocorticoid, and tocilizumab. Despite undergoing intensive treatment, the patient developed respiratory failure and died after 7 days of admission. An autopsy indicated that pulmonary tuberculosis were the ultimate causes of death, while pyelonephritis was controlled.

scholarly journals Pneumocystis Pneumonia During Medicamentous Treatment of Cushing’s Syndrome – A Description of Two Cases

2011 ◽  
Vol 54 (3) ◽  
pp. 127-130 ◽  
Author(s):  
Filip Gabalec ◽  
Alžběta Zavřelová ◽  
Eduard Havel ◽  
Jaroslav Cerman ◽  
Jakub Radocha ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Plasma Cortisol ◽  
Current Practice ◽  
Pneumocystis Pneumonia ◽  
Cushing's Syndrome ◽  
Ectopic Acth Syndrome ◽  
Risk Of Infection ◽  
Laboratory Findings ◽  
Pneumocystis Jiroveci ◽  
Ectopic Acth

Only a few cases of pneumocystis pneumonia (PCP) in Cushing’s syndrome have been published in the literature so far. In the majority of these patients, the pneumonia occurred after reduction of the hypercortisolism with medicamentous treatment. We report two cases of PCP during conservative treatment of hypercortisolism. We describe clinical, imaging and laboratory findings in two patients and review published cases of pneumocystits pneumonia in Cushing’s syndrome. A 60-year-old woman and 20-year-old man with Cushing’s syndrome due to ectopic ACTH syndrome were treated at our department. Both developed pneumocystis pneumonia early after treatment with ketoconazole and ethomidate bromide had been introduced and the levels of cortisol rapidly decreased. PCP prophylaxis in patients with high cortisolemia should be started before treatment of hypercortisolism in current practice. Gradual lowering of plasma cortisol should also reduce the risk of infection by Pneumocystis jiroveci.

scholarly journals Next generation sequencing in early diagnosis of pneumocystis jirovecii pneumonia after chemotherapy: a case report

2019 ◽  
Vol 7 (9) ◽  
pp. 3561
Author(s):  
Donghua Zheng ◽  
Kai Chen ◽  
Fang Xiao ◽  
Na Liu
Keyword(s):  
Case Report ◽  
Next Generation Sequencing ◽  
Early Stage ◽  
Severe Pneumonia ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Next Generation ◽  
Pneumocystis Jiroveci ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

The incidence of Pneumocystis pneumonia is increasing in immunosuppressive patients. How to diagnose and treat Pneumocystis pneumonia in the early stage has become an important issue for clinicians. The development of Next-generation Sequencing (NGS) provides technical support for the diagnosis of Pneumocystis pneumonia. Case report: A 14-year-old male patient was diagnosed with T lymphoblastoma and treated with chemotherapy. After chemotherapy, the patient developed bone marrow suppression and was complicated with severe pneumonia. He was given endotracheal intubation and ventilator assisted respiration. Samples of patients' alveolar lavage fluid were obtained, and Next-generation Sequencing (NGS) was used for diagnosis, confirming the pathogen as Pneumocystis jiroveci, which was treated by TMP/SMX. The patient's condition gradually improved, and was finally removed from ventilator and endotracheal tube. Pneumocystis jiroveci is a common opportunistic pathogen in immunosuppressive patients, and Next-generation Sequencing (NGS) can be used for rapid diagnosis of Pneumocystis pneumonia, thus improving the clinical therapeutic effect. 

scholarly journals Clinical Evaluation of a (1,3)-β-d-Glucan Assay for Presumptive Diagnosis of Pneumocystis jiroveci Pneumonia in Immunocompromised Patients

2009 ◽  
Vol 16 (10) ◽  
pp. 1524-1526 ◽  
Author(s):  
Valerio Del Bono ◽  
Alessandra Mularoni ◽  
Elisa Furfaro ◽  
Emanuele Delfino ◽  
Lorenzo Rosasco ◽  
...  
Keyword(s):  
Cell Wall ◽  
Clinical Evaluation ◽  
Pneumocystis Pneumonia ◽  
Immunocompromised Patients ◽  
Presumptive Diagnosis ◽  
Pneumocystis Jiroveci ◽  
Pneumocystis Jiroveci Pneumonia ◽  
Reliable Marker

ABSTRACT (1,3)-β-d-Glucan (BG) is a component of the Pneumocystis jiroveci cell wall. Thirty-one immunocompromised patients with pneumonia (16 with presumptive pneumocystis pneumonia [PCP] and 15 with non-PCP) were evaluated for serum BG levels. Serum from all 16 presumptive PCP patients and from 2/15 patients with non-PCP was positive for BG. Results indicate that BG is a reliable marker for diagnosing PCP.

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