Cystic lung lesions revealing a Pneumocystis jirovecii and Aspergillus flavus co-infection in an HIV-infected patient

Langlois, M.E.; Lorillou, Marjorie; Ferry, Tristan; Chidiac, Christian; Valour, Florent

doi:10.1016/j.ijid.2015.06.021

Cited by 5 publications

(5 citation statements)

References 4 publications

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“…In addition to coinfection with multiple strains of P. jirovecii, there are considerable case reports of pulmonary coinfection of P. jirovecii with one or more other pathogens, including Aspergillus spp. (479)(480)(481)(482), Cryptococcus spp. (483)(484)(485), Candida spp.…”

Section: Strain Variation Of P Jiroveciimentioning

confidence: 99%

A Molecular Window into the Biology and Epidemiology of Pneumocystis spp

2018

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, a unique atypical fungus with an elusive lifestyle, has had an important medical history. It came to prominence as an opportunistic pathogen that not only can cause life-threatening pneumonia in patients with HIV infection and other immunodeficiencies but also can colonize the lungs of healthy individuals from a very early age. The genus includes a group of closely related but heterogeneous organisms that have a worldwide distribution, have been detected in multiple mammalian species, are highly host species specific, inhabit the lungs almost exclusively, and have never convincingly been cultured, making a fascinating but difficult-to-study organism. Improved molecular biologic methodologies have opened a new window into the biology and epidemiology of. Advances include an improved taxonomic classification, identification of an extremely reduced genome and concomitant inability to metabolize and grow independent of the host lungs, insights into its transmission mode, recognition of its widespread colonization in both immunocompetent and immunodeficient hosts, and utilization of strain variation to study drug resistance, epidemiology, and outbreaks of infection among transplant patients. This review summarizes these advances and also identifies some major questions and challenges that need to be addressed to better understand biology and its relevance to clinical care.

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Section: Strain Variation Of P Jiroveciimentioning

confidence: 99%

A Molecular Window into the Biology and Epidemiology of Pneumocystis spp

2018

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“…Neutropenia or corticosteroid use is associated with nearly half of aspergillosis infections in HIV patients [51]. Additional risk factors for aspergillosis infection in HIV patients include concurrent Pneumocystis jirovecii (PCP) infection and a CD4 count of less than 50-100 cells/mm 3 [52].…”

Section: According To Wang Et Almentioning

confidence: 99%

Aspergillus and Aspergillosis in People with Chronic Diseases

Dabuo,

Xorlali,

Timothy Amoliga

et al. 2023

Infectious Diseases

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Numerous human diseases are caused by Aspergillus species. Mold infections can be more severe in people with weakened immune systems and chronic illnesses. People with underlying chronic conditions are more likely to contract an Aspergillus infection than immunocompromised patients, who are more likely to develop an invasive infection with these opportunistic molds. These disorders include Aspergillus bronchitis, allergic bronchopulmonary aspergillosis, diabetes, cystic fibrosis, severe asthma with fungal sensitivity, and other inflammatory and allergic conditions. The impact of Aspergillus infections in patients with selected chronic infections and the treatment of these infections are discussed in this review along with the most recent research on these topics.

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“…1 IPA are major complications in non-HIV severely immunocompromised patients and account for high mortality. 2 However, the pulmonary coinfection by P. jirovecii and Aspergillus is less frequent, there are only few reports in the literature, [3][4][5][6][7][8][9][10][11][12][13][14][15] and Aspergillus fumigatus is the predominant Aspergillus species in the coinfection. We report a 51-year-old man infected with combined invasive pulmonary Aspergillus terreus and PJP.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary coinfection by Pneumocystis jirovecii and Aspergillus terreus in an ITP patient after corticosteroid therapy: A case report

Wang,

Mao

et al. 2024

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Pneumocystis jirovecii pneumonia and invasive pulmonary aspergillosis are both life‐threatening opportunistic fungal infections. There are only few reports of coinfection by these two fungi in the literature, and Aspergillus fumigatus is the predominant Aspergillus species in the coinfection. We report here the first case of coinfection by Aspergillus terreus and P. jirovecii pneumonia and caspofungin can be an appropriate choice for salvage treatment of the coinfection. A 51‐year‐old man with a history of immune thrombocytopenia treated with prednisone over 2 months was admitted to emergency intensive care unit for acute respiratory failure and a cavity was found on chest computed tomography. Therefore, his trachea was immediately intubated. The patient was treated with a large spectrum of antibiotic regimen, consisting initially of imipenem/cilastatin, moxifloxacin and fluconazole followed by fluconazole, imipenem/cilastatin, vancomycin, trimethoprim–sulphamethoxazole (TMP‐SMZ) and azithromycin. When the polymerase chain reaction analysis of the bronchoalveolar lavage sample revealed P. jirovecii and A. terreus, all the antibiotics were stopped except TMP‐SMZ, and voriconazole was added. Two weeks later, the patient showed clinical improvement but radiological deterioration. Consequently, caspofungin was started for salvage therapy, then the patient showed gradual clinical improvement. He was discharged with oral voriconazole and TMP‐SMZ. The antifungal treatment was continued for 6 months until complete radiological absorption. In conclusion, early bronchoscopy with bronchoalveolar lavage fluid should be considered in order to diagnose and treat promptly in those treated with corticosteroids combined with immunocompromised and caspofungin could be an appropriate choice for salvage treatment of coinfection by P. jirovecii and A. terreus.

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Cystic lung lesions revealing a Pneumocystis jirovecii and Aspergillus flavus co-infection in an HIV-infected patient

Cited by 5 publications

References 4 publications

A Molecular Window into the Biology and Epidemiology of Pneumocystis spp

A Molecular Window into the Biology and Epidemiology of Pneumocystis spp

Aspergillus and Aspergillosis in People with Chronic Diseases

Pulmonary coinfection by Pneumocystis jirovecii and Aspergillus terreus in an ITP patient after corticosteroid therapy: A case report

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