An Outbreak of Pneumocystis Pneumonia in Children With Acute Lymphocytic Leukemia

Ruebush, Trenton K.; Weinstein, Robert A.; Baehner, Robert L.; Wolff, Dominik; Bartlett, Marilyn S.; Gonzles-Crussi, F; Sulzer, Alexander J.; Schultz, Myron G.

doi:10.1001/archpedi.1978.02120270041009

Cited by 42 publications

(25 citation statements)

References 12 publications

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“…The possibility of personto-person transmission of PCP was first raised after reports of PCP outbreaks in oncology and transplant units (35,38,260,272). Many other clusters of PCP cases have since been reported, including both immunosuppressed and HIV patients (56,57,94,215).…”

Section: De Novo Infectionmentioning

confidence: 99%

Colonization by Pneumocystis jirovecii and Its Role in Disease

2012

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SUMMARY Although the incidence of Pneumocystis pneumonia (PCP) has decreased since the introduction of combination antiretroviral therapy, it remains an important cause of disease in both HIV-infected and non-HIV-infected immunosuppressed populations. The epidemiology of PCP has shifted over the course of the HIV epidemic both from changes in HIV and PCP treatment and prevention and from changes in critical care medicine. Although less common in non-HIV-infected immunosuppressed patients, PCP is now more frequently seen due to the increasing numbers of organ transplants and development of novel immunotherapies. New diagnostic and treatment modalities are under investigation. The immune response is critical in preventing this disease but also results in lung damage, and future work may offer potential areas for vaccine development or immunomodulatory therapy. Colonization with Pneumocystis is an area of increasing clinical and research interest and may be important in development of lung diseases such as chronic obstructive pulmonary disease. In this review, we discuss current clinical and research topics in the study of Pneumocystis and highlight areas for future research.

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Section: De Novo Infectionmentioning

confidence: 99%

Colonization by Pneumocystis jirovecii and Its Role in Disease

2012

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“…Vanek and Jirovec described Pneumocystis as the cause of epidemic plasma cell pneumonitis in malnourished or premature infants in institutions in Europe after World War II (45,85,141). Similar cases were reported in the United States in the 1950s.…”

Section: Epidemiologymentioning

confidence: 62%

“…PCP has occurred during therapy with a single agent, including methotrexate, fluorouracil, bleomycin, asparaginase, dactinomycin, and deferoxamine (154). The risk of PCP has been associated with the intensity of the chemotherapy and the duration of neutropenia (73,131,141). The use of cytarabine has been implicated as a strong risk factor for the development of PCP (14,73,152).…”

Section: Hematologic and Nonhematologic Malignanciesmentioning

confidence: 99%

Prevention of Infection Due to Pneumocystis spp. in Human Immunodeficiency Virus-Negative Immunocompromised Patients

2004

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Pneumocystis infection in humans was originally described in 1942. The organism was initially thought to be a protozoan, but more recent data suggest that it is more closely related to the fungi. Patients with cellular immune deficiencies are at risk for the development of symptomatic Pneumocystis infection. Populations at risk also include patients with hematologic and nonhematologic malignancies, hematopoietic stem cell transplant recipients, solid-organ recipients, and patients receiving immunosuppressive therapies for connective tissue disorders and vasculitides. Trimethoprim-sulfamethoxazole is the agent of choice for prophylaxis against Pneumocystis unless a clear contraindication is identified. Other options include pentamidine, dapsone, dapsone-pyrimethamine, and atovaquone. The risk for PCP varies based on individual immune defects, regional differences, and immunosuppressive regimens. Prophylactic strategies must be linked to an ongoing assessment of the patient's risk for disease

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“…and various protozoa. Vavra and Kucera (182) (12,55,76 (31,49,159), and outbreaks in organ transplant units (72,161,176) suggest person-to-person transmission. A report of increased incidence of Pneumocystis infection in immunosuppressed patients without AIDS in an institution where there was an increased incidence of AIDS is suggestive (74 (101) showed that none of seven infants had antibody specific to P. carinii but that seven of eight normal adults did have specific antibody.…”

Section: Taxonomymentioning

confidence: 99%

“…In fact, workers tried to determine why P. carinii had such a clear predilection for lung tissue and seemed to be confined to it. Now reports have shown infection in almost every organ; manifestations include thymoma (27), choroiditis (117,150), pneumocystoma (60), necrotizing vasculitis (112), and infections of the small intestine (28), liver (142), spleen (181), bone marrow (151,158,159), ear (165,170), and skin (35 (8). Open-lung biopsy, historically the method of choice (7,93) (171).…”

Section: Taxonomymentioning

confidence: 99%

Pneumocystis carinii, an opportunist in immunocompromised patients

Bartlett

Smith

1991

Clin Microbiol Rev

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Pneumocystis carinii has been recognized as a cause of pneumonia in immunocompromised patients for over 40 years. Until the 1980s, Pneumocystis pneumonia (pneumocystosis) was most often seen in patients undergoing chemotherapy for malignancy or transplantation. Infection could be prevented by trimethoprim-sulfamethoxazole prophylaxis; thus, it was an uncommon clinical problem. With the onset of the AIDS epidemic, Pneumocystis pneumonia has become a major problem in the United States because it develops in approximately 80% of patients with AIDS and because almost two-thirds of patients have adverse reactions to anti-Pneumocystis drugs. Thus, physicians and laboratories in any community may be called upon to diagnose and provide care for patients with Pneumocystis pneumonia. The classification of the organism is currently controversial, but it is either a protozoan or a fungus. P. carinii appears to be acquired during childhood by inhalation and does not cause clinical disease in healthy persons but remains latent. If the person becomes immunosuppressed, the latent infection may become activated and lead to clinical disease. Damage of type I pneumocytes by Pneumocystis organisms leads to the foamy alveolar exudate which is characteristic of the disease. Diagnosis is established by morphologic demonstration of Pneumocystis organisms in material from the lungs. Current efforts to find better anti-Pneumocystis drugs should provide more effective therapy and prophylaxis.

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An Outbreak of Pneumocystis Pneumonia in Children With Acute Lymphocytic Leukemia

Cited by 42 publications

References 12 publications

Colonization by Pneumocystis jirovecii and Its Role in Disease

Colonization by Pneumocystis jirovecii and Its Role in Disease

Prevention of Infection Due to Pneumocystis spp. in Human Immunodeficiency Virus-Negative Immunocompromised Patients

Pneumocystis carinii, an opportunist in immunocompromised patients

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