Journal Article10.1056/NEJMRA032588
Medical progress: Pneumocystis pneumonia
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TL;DR: Advances that have resulted from studies of the cell biology, biochemistry, and genetics of pneumocystis in the past several years are summarized and recommendations for the diagnosis and treatment are included, as well as for prophylaxis and treatment.
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Abstract: N Engl J Med 2004;350:2487-98. Copyright © 2004 Massachusetts Medical Society. neumocystis pneumonia remains the most prevalent opportun istic infection in patients infected with the human immunodeficiency virus (HIV). 1,2 First identified as a protozoan nearly 100 years ago and reclassified as a fungus in 1988, pneumocystis cannot be propagated in culture. 3-6 Few treatment options exist for patients with pneumocystis pneumonia. The number of patients who are receiving chronic immunosuppressive medication or who have an altered immune system and are thus at risk for pneumocystis pneumonia is rapidly growing. 2 Although the prevalence of the acquired immunodeficiency syndrome (AIDS) has decreased in the Western hemisphere owing to the routine use of highly active antiretroviral therapy (HAART), many patients worldwide do not have the resources for HAART. 1 The increased reservoir for infection among such patients leads to concern that resistance to trimethoprim–sulfamethoxazole, the most common treatment for pneumocystis pneumonia , will emerge, although this has yet to happen. The application of molecular techniques to the study of pneumocystis has provided new insights into the complex cell biology of this fungus. In this article we summarize advances that have resulted from studies of the cell biology, biochemistry, and genetics of pneumocystis in the past several years and include recommendations for the diagnosis of pneumocystis pneumonia, as well as for prophylaxis and treatment.
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Citations
Conserved natural IgM antibodies mediate innate and adaptive immunity against the opportunistic fungus Pneumocystis murina
Rekha R. Rapaka,David M. Ricks,John F. Alcorn,Kong Chen,Shabaana A. Khader,Mingquan Zheng,Scott E. Plevy,Eva Bengtén,Jay K. Kolls,Jay K. Kolls +9 more
TL;DR: Natural IgM antibodies in diverse species recognize conserved carbohydrates in fungal cell walls and influence early host defense against Pneumocystis in mice.
Diagnosis of Pneumocystis jirovecii Pneumonia in Immunocompromised Patients by Real-Time PCR: a 4-Year Prospective Study
Florence Robert-Gangneux,Sorya Belaz,Matthieu Revest,Pierre Tattevin,Stéphane Jouneau,Olivier Decaux,Sylviane Chevrier,Yves Le Tulzo,Jean-Pierre Gangneux +8 more
TL;DR: Quantitative real-time PCR is a useful tool to diagnose PCP in non-HIV patients, and treatment might be better targeted through a multicomponent algorithm including both clinical/radiological parameters and qPCR results.
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PCR Diagnosis of Pneumocystis Pneumonia: a Bivariate Meta-Analysis
TL;DR: A bivariate meta-analysis showed that respiratory specimen PCR results are sufficient to confirm or exclude the disease for at-risk patients suspected of having Pneumocystis pneumonia.
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Serum (1-3)-β-d-Glucan as a Tool for Diagnosis of Pneumocystis jirovecii Pneumonia in Patients with Human Immunodeficiency Virus Infection or Hematological Malignancy
Stefanie Desmet,Eric Van Wijngaerden,Johan Maertens,Jan Verhaegen,Eric Verbeken,Paul De Munter,Wouter Meersseman,Britt Van Meensel,Johan Van Eldere,Katrien Lagrou +9 more
TL;DR: Serum BG testing looks promising for the noninvasive diagnosis of PCP and a higher cutoff value than for the diagnosis of invasive aspergillosis or candidiasis could be used safely and will improve the specificity of the test.
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Pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis
Shunsuke Mori,Mineharu Sugimoto +1 more
TL;DR: In this article, a review of the recent medical literature regarding asymptomatic colonization and its clinical significance, transmission modes of infection and prophylaxis of pneumonia (PCP) outbreaks among RA patients can occur through person-to-person transmission in outpatient facilities.
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TL;DR: Phylogenetic analysis of Pneumocystis 16S-like rRNA demonstrates it to be a member of the Fungi, revealing that the plant, animal and fungal lineages are distinct from the diverse spectrum of protozoan lineages.
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