Pneumocystis pneumonia suspected cases in 604 non-HIV and HIV patients

Bienvenu, Anne‐Lise; Traore, Karim; Плеханова, И. И.; Bouchrik, M.; Bossard, Cécile; Picot, Stéphane

doi:10.1016/j.ijid.2016.03.018

Cited by 103 publications

(102 citation statements)

References 37 publications

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“…Both patients undergoing hematopoietic stem cell transplantation (HSCT) and patients undergoing solid organ transplantation (SOT) are at risk of PCP (5–15% of cases), which is higher after allogenic versus autologous HSCT and after heart and/or lung SOT versus for instance renal transplantation [19, 20, 25, 26]. …”

Section: Epidemiology and Risk Groupsmentioning

confidence: 99%

Clinical, Diagnostic, and Treatment Disparities between HIV-Infected and Non-HIV-Infected Immunocompromised Patients with Pneumocystis jirovecii Pneumonia

et al. 2018

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The substantial decline in the Pneumocystis jirovecii pneumonia (PCP) incidence in HIV-infected patients after the introduction of antiretroviral therapy (ART) in resource-rich settings and the growing number of non-HIV-infected immunocompromised patients at risk leads to considerable epidemiologic changes with clinical, diagnostic, and treatment consequences for physicians. HIV-infected patients usually develop a subacute course of disease, while non-HIV-infected immunocompromised patients are characterized by a rapid disease progression with higher risk of respiratory failure and higher mortality. The main symptoms usually include exertional dyspnea, dry cough, and subfebrile temperature or fever. Lactate dehydrogenase may be elevated. Typical findings on computed tomography scans of the chest are bilateral ground-glass opacities with or without cystic lesions, which are usually associated with the presence of AIDS. Empiric treatment should be initiated as soon as PCP is suspected. Bronchoalveolar lavage has a higher diagnostic yield compared to induced sputum. Immunofluorescence is superior to conventional staining. A combination of different diagnostic tests such as microscopy, polymerase chain reaction, and (1,3)-β-D-glucan is recommended. Trimethoprim/sulfamethoxazole for 21 days is the treatment of choice in adults and children. Alternative treatment regimens include dapsone with trimethoprim, clindamycin with primaquine, atovaquone, or pentamidine. Patients with moderate to severe disease should receive adjunctive corticosteroids. In newly diagnosed HIV-infected patients with PCP, ART should be initiated as soon as possible. In non-HIV-infected immunocompromised patients, improvement of the immune status should be discussed (e.g., temporary reduction of immunosuppressive agents). PCP prophylaxis is effective and depends on the immune status of the patient and the underlying immunocompromising disease.

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Section: Epidemiology and Risk Groupsmentioning

confidence: 99%

Clinical, Diagnostic, and Treatment Disparities between HIV-Infected and Non-HIV-Infected Immunocompromised Patients with Pneumocystis jirovecii Pneumonia

et al. 2018

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“…Four of 5 cases occurred in previously untreated patients receiving ibrutinib in first-line and presented as mild disease, varying from asymptomatic multifocal pulmonary infiltrates to chronic cough. Atypical presentations of PCP have been described, 7,12 but it is unclear if mild disease reflects the natural history of PCP in this patient population or increased vigilance and early identification.…”

Section: Case #2mentioning

confidence: 99%

“…However, due to improved treatment of HIV, some institutions now find most PCP cases in HIV-negative immunocompromised individuals. 12 HIV-negative patients present with a lower burden of pathogen, which limits the diagnostic sensitivity of staining methods. 12 Although some controversy remains regarding the significance of a positive PCR with a negative stain, 13,14 in our cases, the presence of a compatible clinical picture, lack of other likely pathogens, and response to anti-Pneumocystis treatment allow us to make the diagnosis of PCP by PCR only.…”

Section: Case #2mentioning

confidence: 99%

Atypical Pneumocystis jirovecii pneumonia in previously untreated patients with CLL on single-agent ibrutinib

Ahn

Jerussi

Farooqui³

et al. 2016

Blood

154

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“…Interestingly, the disease dynamics differs between HIV and non-HIV cases. While the latter is an acute disease developing within days with high mortality, the disease shows a much slower progression in HIV/AIDS patients [70]. Chest computed tomography usually shows symmetric ground glass opacities.…”

Section: Pulmonary Fungal Infectionsmentioning

confidence: 99%

Pulmonary Diseases in Refugees and Migrants in Europe

et al. 2018

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More than 2 million people fleeing conflict, persecution, and poverty applied for asylum between 2015 and 2016 in the European Union. Due to this, medical practitioners in recipient countries may be facing a broader spectrum of conditions and unusual presentations not previously encountered, including a wide range of infections with pulmonary involvement. Tuberculosis is known to be more common in migrants and has been covered broadly in other publications. The scope of this review was to provide an overview of exotic infections with pulmonary involvement that could be encountered in refugees and migrants and to briefly describe their epidemiology, diagnosis, and management. As refugees and migrants travel from numerous countries and continents, it is important to be aware of the various organisms that might cause disease according to the country of origin. Some of these diseases are very rare and geographically restricted to certain regions, while others have a more cosmopolitan distribution. Also, the spectrum of severity of these infections can vary from very benign to severe and even life-threatening. We will also describe infectious and noninfectious complications that can be associated with HIV infection as some migrants might originate from high HIV prevalence countries in sub-Saharan Africa. As the diagnosis and treatment of these diseases can be challenging in certain situations, patients with suspected infection might require referral to specialized centers with experience in their management. Additionally, a brief description of noncommunicable pulmonary diseases will be provided.

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Pneumocystis pneumonia suspected cases in 604 non-HIV and HIV patients

Cited by 103 publications

References 37 publications

Clinical, Diagnostic, and Treatment Disparities between HIV-Infected and Non-HIV-Infected Immunocompromised Patients with <b><i>Pneumocystis jirovecii</i></b> Pneumonia

Clinical, Diagnostic, and Treatment Disparities between HIV-Infected and Non-HIV-Infected Immunocompromised Patients with <b><i>Pneumocystis jirovecii</i></b> Pneumonia

Atypical Pneumocystis jirovecii pneumonia in previously untreated patients with CLL on single-agent ibrutinib

Pulmonary Diseases in Refugees and Migrants in Europe

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