<i>Pneumocystis</i>
            Workshop: 10th Anniversary Summary

Beck, James M.; Cushion, Melanie T.

doi:10.1128/ec.00309-08

Cited by 38 publications

(25 citation statements)

References 75 publications

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“…32,33 These findings indicate that, once host immune response to Pneumocystis infection is excessive, pulmonary inflammation potently contributes to lung injury. 5,20 The extent of the host immune response, especially neutrophilic lung inflammation, could be the determinant of the disease severity.…”

Section: Cd4mentioning

confidence: 99%

“…Early in the AIDS epidemic, PCP occurred in 46% of the AIDS patients who did not receive chemoprophylaxis for PCP. 5 Nowadays, AIDS-related PCP occurs primarily among individuals unaware that they have HIV infection and is an AIDS-defining illness. 25 20 Although decreasing CD4 + count is the strongest predictor of risk for opportunistic infection, increasing viral load (ie, HIV-RNA in plasma) is independently associated with increased risk.…”

Section: Cd4mentioning

confidence: 99%

“…Because Pneumocystis cannot readily be cultured in the laboratory, the microscopic demonstration of the organisms in respiratory specimens has been the golden standard for the diagnosis of PCP. 2,5,25 Cysts can be stained with Grocott-Gomori methenaminesilver, toluidine blue O, or calcofluor white. Trophic forms, which predominate over the cyst forms during development of PCP, can be detected with Wright-Giemsa and DiffQuik staining.…”

mentioning

confidence: 99%

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PneumocystisPneumonia in Human Immunodeficiency Virus–infected Adults and Adolescents: Current Concepts and Future Directions

Tasaka

2015

Clin Med Insights Circ Respir Pulm Med

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Pneumocystis jirovecii pneumonia (PCP) is one of the most common opportunistic infections in human immunodeficiency virus-infected adults. Colonization of Pneumocystis is highly prevalent among the general population and could be associated with the transmission and development of PCP in immunocompromised individuals. Although the microscopic demonstration of the organisms in respiratory specimens is still the golden standard of its diagnosis, polymerase chain reaction has been shown to have a high sensitivity, detecting Pneumocystis DNA in induced sputum or oropharyngeal wash. Serum β-d-glucan is useful as an adjunctive tool for the diagnosis of PCP. High-resolution computed tomography, which typically shows diffuse groundglass opacities, is informative for the evaluation of immunocompromised patients with suspected PCP and normal chest radiography. Trimethoprimsulfamethoxazole (TMP-SMX) is the first-line agent for the treatment of mild to severe PCP, although it is often complicated with various side effects. Since TMP-SMX is widely used for the prophylaxis, the putative drug resistance is an emerging concern.

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Section: Cd4mentioning

confidence: 99%

Section: Cd4mentioning

confidence: 99%

mentioning

confidence: 99%

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PneumocystisPneumonia in Human Immunodeficiency Virus–infected Adults and Adolescents: Current Concepts and Future Directions

Tasaka

2015

Clin Med Insights Circ Respir Pulm Med

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“…Despite the availability of direct and indirect identification methods, the diagnosis of PCP remains difficult (30)(31)(32). Indeed, the P. jirovecii fungus is difficult to grow in culture, and the sensitivity of direct microscopic examination is low (26,27,(33)(34)(35).…”

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confidence: 99%

Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients

et al. 2016

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dPneumocystis jirovecii pneumonia (PCP) is an acute and life-threatening lung disease caused by the fungus Pneumocystis jirovecii. The presentation of PCP in HIV-positive patients is well-known and consists of a triad of dyspnea, fever, and cough, whereas the presentation of PCP in HIV-negative patients is atypical and consists of a sudden outbreak, O 2 desaturation, and a rapid lethal outcome without therapy. Despite the availability of direct and indirect identification methods, the diagnosis of PCP remains difficult. The cycle threshold (C T ) values obtained by quantitative PCR (qPCR) allow estimation of the fungal burden. The more elevated that the fungal burden is, the higher the probability that the diagnosis is pneumonia. The purposes of the present study were to evaluate the C T values to differentiate colonization and pneumonia in a population of immunocompromised patients overall and patients stratified on the basis of their HIV infection status. Testing of bronchoalveolar lavage (BAL) fluid samples from the whole population of qPCR-positive patients showed a mean C T value for patients with PCP of 28 (95% confidence interval [CI], 26 to 30) and a mean C T value for colonized patients of 35 (95% CI, 34 to 36) (P < 10 ؊3 ). For the subgroup of HIV-positive patients, we demonstrated that a C T value below 27 excluded colonization and a C T value above 30 excluded PCP with a specificity of 100% and a sensitivity of 80%, respectively. In the subgroup of HIV-negative patients, we demonstrated that a C T value below 31 excluded colonization and a C T value above 35 excluded PCP with a specificity of 80% and a sensitivity of 80%, respectively. Thus, qPCR of BAL fluid samples is an important tool for the differentiation of colonization and pneumonia in P. jirovecii-infected immunocompromised patients and patients stratified on the basis of HIV infection status with different C T values.

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“…Pneumocystis spp. are yeast-like fungi that reside extracellularly in lung alveoli and are hypothesized to replicate via a biphasic life cycle (3). The smaller vegetative trophic forms reproduce asexually through binary fission, and asci are formed by a sexual process.…”

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confidence: 99%

Characterization of a Distinct Host Response Profile to Pneumocystismurina Asci during Clearance of Pneumocystis Pneumonia

et al. 2013

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؉ T cell influx and expression of macrophage inflammatory response markers. A more robust cellular response was also observed in the untreated mice, with increased numbers of macrophages and neutrophils that were associated with greater lung damage. Markers of a Th17 response were also elevated in the untreated mice. These results suggest that the host mounts unique responses to asci and trophic forms. That these 2 life cycle stages provoked distinct host response profiles has significant implications for clearance and interpretation of the host immune responses to PcP.

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Pneumocystis Workshop: 10th Anniversary Summary

Abstract: . 2003. Pneumocystis carinii cell wall beta-glucan induces release of macrophage inflammatory protein-2 from alveolar epithelial cells via a lactosylceramide-mediated mechanism.

Cited by 38 publications

References 75 publications

PneumocystisPneumonia in Human Immunodeficiency Virus–infected Adults and Adolescents: Current Concepts and Future Directions

PneumocystisPneumonia in Human Immunodeficiency Virus–infected Adults and Adolescents: Current Concepts and Future Directions

Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients

Characterization of a Distinct Host Response Profile to Pneumocystismurina Asci during Clearance of Pneumocystis Pneumonia

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