Search results for "pneumocystis"

Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients

2018

Abstract Background The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. Methods We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. Results At least 1 risk factor for immunocompromis…

Evidence of the Red-Queen Hypothesis from Accelerated Rates of Evolution of Genes Involved in Biotic Interactions in Pneumocystis.

2018

Pneumocystis species are ascomycete fungi adapted to live inside the lungs of mammals. These ascomycetes show extensive stenoxenism, meaning that each species of Pneumocystis infects a single species of host. Here, we study the effect exerted by natural selection on gene evolution in the genomes of three Pneumocystis species. We show that genes involved in host interaction evolve under positive selection. In the first place, we found strong evidence of episodic diversifying selection in Major surface glycoproteins (Msg). These proteins are located on the surface of Pneumocystis and are used for host attachment and probably for immune system evasion. Consistent with their function as antigen…

Ultrastructural study on human lung in alveolitis versus pulmonary fibrosis

1993

Lung specimens of 21 patients with diffuse interstitial lung disease were examined. The present ultrastructural study outlines the topography and distribution of inflammatory changes in the interstitium, endothelium, and in pneumocytes and phagocytes. Alveolitis is characterized by marked regenerative activity of type II pneumocytes (cuboid metaplasia), intraluminal macrophage accumulation, endothelial swelling, multilamination of the endothelial basement membrane, pericapillary edema, and primarily by cellular infiltrates in the interstitial space. The most prominent feature of the interstitium in pulmonary fibrosis is the lack of immunoinflammatory cells. In some areas there is a marked a…

Detection of Mycoplasma sp. in bronchoalveolar lavage of AIDS patients with pulmonary infiltrates.

1996

We examined 486 bronchoalveolar lavages (BAL) including 32 from AIDS patients with pulmonary infiltrates and 20 from patients with leukemia or after transplantation. Mycoplasmas were found in 4/32 (12.5%) HIV-positive patients compared to 4/454 (0.9%) HIV-negative patients (p0.001). All of these four HIV-positive patients suffered from advanced infection (CD4 counts100/microL) and developed complications (Pcp, n = 2, recurrent bacterial pneumonia, n = 1, pulmonary Kaposi sarcoma, n = 1). No mycoplasmas were detected in 20 immunosuppressed patients with leukemia or after transplantation. Our data indicate that AIDS patients may be more often colonised or infected by mycoplasmas than HIV-nega…

Antimicrobial prophylaxis in patients with immune thrombocytopenia treated with rituximab: a retrospective multicenter analysis

2021

The primary aim of this study was to describe the use of primary anti-infective prophylaxis (AP) in common clinical practice in patients affected by immune thrombocytopenia (ITP) and treated with RTX. Population studied consisted of patients affected by ITP (age ≥ 18 years) who had received at least one dose of RTX from January 2008 to June 2018. Five Italian haematology centres participated in the current study. Data were retrospectively collected: demographic data (age, gender), concomitant comorbidities and previous therapies for ITP, characteristics of AP, the occurrence of infections and their management. The ITP cohort consisted of 67 patients sub-grouped into two categories according…

Factors associated with Pneumocystis colonization and circulating genotypes in chronic obstructive pulmonary disease patients with acute exacerbation…

2021

Abstract Pneumocystis jirovecii colonization is frequent during chronic obstructive pulmonary disease (COPD) and patients constitute potential contributors to its interhuman circulation. However, the existence of an environmental reservoir cannot be excluded. We assessed the prevalence and factors associated with Pneumocystis colonization during COPD, and studied circulation between patients and their domestic environment. Pneumocystis molecular detection and mtLSU genotyping were performed in oro-pharyngeal washes (OPW) sampled in 58 patients with COPD acute exacerbation, and in indoor dust, sampled in patients’ homes using electrostatic dust collectors (EDCs). Lung and systemic inflammati…

Clinical significance of Pneumocystis jirovecii DNA detection by real-time PCR in hematological patient respiratory specimens

2020

Evaluation of the Amplex eazyplex Loop-Mediated Isothermal Amplification Assay for Rapid Diagnosis of Pneumocystis jirovecii Pneumonia

2020

ABSTRACT Quantitative PCR (qPCR) assays are the gold standard for diagnosis of Pneumocystis jirovecii pneumonia (PCP). However, they are laborious and require skilled personnel. Therefore, execution outside regular working hours of the molecular biology laboratory is limited. The eazyplex P. jirovecii assay (PJA) uses loop-mediated isothermal amplification for detection of P. jirovecii. It is performed directly with respiratory specimens, without the need for special skills, and delivers a result within 3 to 25 min. The goal of our study was to compare the performance of the eazyplex PJA with that of established P. jirovecii qPCR assays. All archived bronchoalveolar lavage fluid (BALF) samp…

Criptococosis sistémica y neumocistosis en un paciente VIH-positivo

1995

La criptococosis es una de las principales infecciones oportunistas que afectan a los enfermos de sida. Las manifestaciones neurologicas constituyen la forma mas frecuente de manifestarse esta infeccion fungica, siendo la afectacion pulmonar mucho menos aparente clinicamente. Se presenta el caso de un paciente atendido en urgencias del hospital, con un cuadro de insuficiencia respiratoria aguda, que evoluciono fatalmente. Los estudios microbiologicos e histopatologicos demostraron la presencia simultanea de Cryptococcus neoformans y de Pneumocystis carinii en pulmon. Se discute esta forma de presentacion de la criptococosis, en ausencia de sintomatologia neurologica, y la trascendencia de l…

Performance of existing definitions and tests for the diagnosis of invasive fungal diseases other than invasive candidiasis and invasive aspergillosi…

2021

Diagnòstic; Malalties fúngiques invasores; Pneumocystis Diagnóstico; Enfermedades fúngicas invasivas; Pneumocystis Diagnosis; Invasive fungal diseases; Pneumocystis The Fungal Infections Definitions in Intensive Care Unit (ICU) patients (FUNDICU) project aims to provide standard sets of definitions for invasive fungal diseases (IFDs) in critically ill, adult patients, including invasive aspergillosis (IA), invasive candidiasis (IC), Pneumocystis jirovecii pneumonia (PJP), and other non-IA, non-IC IFDs. The first step of the project was the conduction of separated systematic reviews of the characteristics and applicability to critically ill, adult patients outside classical populations at ri…