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Pneumocystis jirovecii--from a commensal to pathogen: clinical and diagnostic review.

Sokulska M, Kicia M, Wesołowska M, Hendrich AB - Parasitol. Res. (2015)

Bottom Line: In contrast, fungal invasion in immunocompetent people usually leads to asymptomatic colonization, which frequent incidence among healthy infants has even suggested the possibility of its association with sudden unexpected infant death syndrome.In the face of emerging strains with different epidemiological profiles resulting from genetic diversity, including drug-resistant genotypes, the colonization phenomenon desires particular attention, discussed in this article.We also summarize specific and sensitive methods, required for detection of Pneumocystis invasion and for distinguish colonization from the disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Biology and Medical Parasitology, Wrocław Medical University, ul. Mikulicza-Radeckiego 9, 50-367, Wrocław, Poland.

ABSTRACT
Pneumocystis pneumonia is an opportunistic disease caused by invasion of unicellular fungus Pneumocystis jirovecii. Initially, it was responsible for majority of morbidity and mortality cases among HIV-infected patients, which later have been reduced due to the introduction of anti-retroviral therapy, as well as anti-Pneumocystis prophylaxis among these patients. Pneumocystis pneumonia, however, is still a significant cause of mortality among HIV-negative patients being under immunosuppression caused by different factors, such as transplant recipients as well as oncologically treated ones. The issue of pneumocystosis among these people is particularly emphasized in the article, since rapid onset and fast progression of severe symptoms result in high mortality rate among these patients, who thereby represent the group of highest risk of developing Pneumocystis pneumonia. In contrast, fungal invasion in immunocompetent people usually leads to asymptomatic colonization, which frequent incidence among healthy infants has even suggested the possibility of its association with sudden unexpected infant death syndrome. In the face of emerging strains with different epidemiological profiles resulting from genetic diversity, including drug-resistant genotypes, the colonization phenomenon desires particular attention, discussed in this article. We also summarize specific and sensitive methods, required for detection of Pneumocystis invasion and for distinguish colonization from the disease.

No MeSH data available.


Related in: MedlinePlus

Major issues related to PcP in non-HIV patients
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Related In: Results  -  Collection


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Fig1: Major issues related to PcP in non-HIV patients

Mentions: Another group of patients which are still at high risk of infection are non-HIV individuals with immunodeficiency caused by receiving cytotoxic and immunosupressive therapy for solid tumors, hematological malignancies or inflammatory and rheumatic diseases, as well as organ transplant recipients (Li et al. 2014). Increased number of cases of PcP in this group may be related to greater frequency of applications of immunosuppressants, usage of their higher doses, or to different combination of immunsuppressive agents which lead to enhanced susceptibility of patient to Pneumocystis infection (Ward and Donald 1999). In addition, due to improvements in medical care, more people with immune deficiency survive, remaining at risk of PcP. On the other hand, non-HIV patients are less aware that they are at risk of PcP, which often contributes to prolonged time from the onset of symptoms to treatment initiation. Thus, this group of patients represents a novel, serious public health care problem (Fig. 1).Fig. 1


Pneumocystis jirovecii--from a commensal to pathogen: clinical and diagnostic review.

Sokulska M, Kicia M, Wesołowska M, Hendrich AB - Parasitol. Res. (2015)

Major issues related to PcP in non-HIV patients
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4562001&req=5

Fig1: Major issues related to PcP in non-HIV patients
Mentions: Another group of patients which are still at high risk of infection are non-HIV individuals with immunodeficiency caused by receiving cytotoxic and immunosupressive therapy for solid tumors, hematological malignancies or inflammatory and rheumatic diseases, as well as organ transplant recipients (Li et al. 2014). Increased number of cases of PcP in this group may be related to greater frequency of applications of immunosuppressants, usage of their higher doses, or to different combination of immunsuppressive agents which lead to enhanced susceptibility of patient to Pneumocystis infection (Ward and Donald 1999). In addition, due to improvements in medical care, more people with immune deficiency survive, remaining at risk of PcP. On the other hand, non-HIV patients are less aware that they are at risk of PcP, which often contributes to prolonged time from the onset of symptoms to treatment initiation. Thus, this group of patients represents a novel, serious public health care problem (Fig. 1).Fig. 1

Bottom Line: In contrast, fungal invasion in immunocompetent people usually leads to asymptomatic colonization, which frequent incidence among healthy infants has even suggested the possibility of its association with sudden unexpected infant death syndrome.In the face of emerging strains with different epidemiological profiles resulting from genetic diversity, including drug-resistant genotypes, the colonization phenomenon desires particular attention, discussed in this article.We also summarize specific and sensitive methods, required for detection of Pneumocystis invasion and for distinguish colonization from the disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Biology and Medical Parasitology, Wrocław Medical University, ul. Mikulicza-Radeckiego 9, 50-367, Wrocław, Poland.

ABSTRACT
Pneumocystis pneumonia is an opportunistic disease caused by invasion of unicellular fungus Pneumocystis jirovecii. Initially, it was responsible for majority of morbidity and mortality cases among HIV-infected patients, which later have been reduced due to the introduction of anti-retroviral therapy, as well as anti-Pneumocystis prophylaxis among these patients. Pneumocystis pneumonia, however, is still a significant cause of mortality among HIV-negative patients being under immunosuppression caused by different factors, such as transplant recipients as well as oncologically treated ones. The issue of pneumocystosis among these people is particularly emphasized in the article, since rapid onset and fast progression of severe symptoms result in high mortality rate among these patients, who thereby represent the group of highest risk of developing Pneumocystis pneumonia. In contrast, fungal invasion in immunocompetent people usually leads to asymptomatic colonization, which frequent incidence among healthy infants has even suggested the possibility of its association with sudden unexpected infant death syndrome. In the face of emerging strains with different epidemiological profiles resulting from genetic diversity, including drug-resistant genotypes, the colonization phenomenon desires particular attention, discussed in this article. We also summarize specific and sensitive methods, required for detection of Pneumocystis invasion and for distinguish colonization from the disease.

No MeSH data available.


Related in: MedlinePlus