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Serum Antibody Levels to the Pneumocystis jirovecii Major Surface Glycoprotein in the Diagnosis of P. jirovecii Pneumonia in HIV+ Patients  [PDF] Kpandja Djawe,Laurence Huang,Kieran R. Daly,Linda Levin,Judy Koch,Alexandra Schwartzman,Serena Fong,Brenna Roth,Anuradha Subramanian,Katherine Grieco,Leah Jarlsberg,Peter D. Walzer PLOS ONE , 2012, DOI: 10.1371/journal.pone.0014259 Abstract: Pneumocystis jirovecii remains an important cause of fatal pneumonia (Pneumocystis pneumonia or PcP) in HIV+ patients and other immunocompromised hosts. Despite many previous attempts, a clinically useful serologic test for P. jirovecii infection has never been developed. Save   Related Articles

Ambient Air Pollution Associated with Suppressed Serologic Responses to Pneumocystis jirovecii in a Prospective Cohort of HIV-Infected Patients with Pneumocystis Pneumonia  [PDF] Robert J. Blount, Kpandja Djawe, Kieran R. Daly, Leah G. Jarlsberg, Serena Fong, John Balmes, Robert F. Miller, Peter D. Walzer, Laurence Huang, on behalf of the International HIV-associated Opportunistic Pneumonias (IHOP) Study. PLOS ONE , 2013, DOI: 10.1371/journal.pone.0080795 Abstract: Background Ambient air pollution (AAP) may be associated with increased risk for Pneumocystis pneumonia (PCP). The mechanisms underlying this association remain uncertain. Objectives To determine if real-life exposures to AAP are associated with suppressed IgM antibody responses to P. jirovecii in HIV-infected (HIV+) patients with active PCP, and to determine if AAP, mediated by suppressed serologic responses to Pneumocystis, is associated with adverse clinical outcomes. Methods We conducted a prospective cohort study in HIV+ patients residing in San Francisco and admitted to San Francisco General Hospital with microscopically confirmed PCP. Our AAP predictors were ambient air concentrations of particulate matter of < 10 μm in diameter (PM10) and < 2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide (SO2) measured immediately prior to hospital admission and 2 weeks prior to admission. Our primary outcomes were the IgM serologic responses to four recombinant P. jirovecii major surface glycoprotein (Msg) constructs: MsgC1, MsgC3, MsgC8, and MsgC9. Results Elevated PM10 and NO2 exposures immediately prior to and two weeks prior to hospital admission were associated with decreased IgM antibody responses to P. jirovecii Msg. For exposures immediately prior to admission, every 10 μg/m3 increase in PM10 was associated with a 25 to 35% decrease in IgM responses to Msg (statistically significant for all the Msg constructs), and every 10 ppb increase in NO2 was associated with a 19-45% decrease in IgM responses to Msg (statistically significant for MsgC8 and MsgC9). Similar findings were seen with exposures two weeks prior to admission, but for fewer of the Msg constructs. Conclusions Real life exposures to PM10 and NO2 were associated with suppressed IgM responses to P. jirovecii Msg in HIV+ patients admitted with PCP, suggesting a mechanism of immunotoxicity by which AAP increases host susceptibility to pulmonary infection. Save   Related Articles

Neumonía por Pneumocystis jirovecii Zunen Hernández Puentes,Yaimara; Pi？era,Bárbara Mercedes Paula; Salinas Olivares,Mercedes; Vila González,William; Casa de Valle Castro,Midalys; Revista Cubana de Medicina Militar , 2010, Abstract: objective: to present the atypical case of a hiv-negative patient, deceased from pneumocystis jirovecii more frequent in persons infected with the aids virus and in those underwent transplantation. description: a patient with a history of alcoholism, asthma, respiratory symptoms and fever, hiv-negative, with a torpid course deceased at 11 days after admission. lung: peripheral emphysema, scattered zones of a fleshy red appearance mixed with not much aired zones and impasted. intervention: a clinical necropsy was carried out where the direct cause of death was from pneumocystis jirovecii, diagnosed using hematoxylin-esosin stain proving the presence of a characteristic foamy edema. in the silver methenamine stain it was possible to corroborate the presence of the microorganism. conclusions: in this case the leading cause of death was pneumocystis jirovecii pneumonia, an opportunistic pathogen frequently reported a cause of death in hiv-aids patients and also in those immunocompromised due to other causes, e.g. those with transplantation. Save   Related Articles

Pneumocystis jirovecii infection of the external auditory canal CM Samuel, S Maistry, E Meyer, A Whitelaw Southern African Journal of HIV Medicine , 2010, Abstract: Pneumocystis jirovecii is well known to cause interstitial plasma cell pneumonia in immunocompromised patients. It has been implicated as a rare cause of infections in other anatomical sites.1 We report a rare case of P. jirovecii infection of the external auditory canal. This was the first manifestation of a previously unknown HIV infection. Save   Related Articles

Neumonía por Pneumocystis jirovecii Pneumocystic jirovecii pneumonia  [cached] Yaimara Zunen Hernández Puentes,Bárbara Mercedes Paula Pi？era,Mercedes Salinas Olivares,William Vila González Revista Cubana de Medicina Militar , 2010, Abstract: OBJETIVO: presentar un caso atípico de una paciente VIH negativo, fallecida por Pneumocystis jirovecii, más frecuente en personas infectadas por el virus del SIDA y postrasplantados. DESCRIPCIóN: se presenta una paciente con antecedentes de alcoholismo, asma, con síntomas respiratorios y fiebre, VIH negativo, con evolución tórpida que fallece a los 11 días del ingreso. Pulmones: enfisema periférico, zonas dispersas de aspecto rojo carnoso entre mezclado con zonas poco aireadas, empastadas. INTERVENCIóN: se realizó autopsia clínica encontrándose como causa directa de la muerte, neumonía por Pneumocystis jirovecii, diagnosticado con coloración de hematoxilina y eosina donde se observó presencia del edema espumoso característico. Se corroboró con coloración de plata metenamina donde se pudo observar el microorganismo. CONCLUSIONES: el caso presentó como causa directa de la muerte una neumonía por Pneumocystis jirovecii, patógeno oportunista reportado con frecuencia como causa de muerte en pacientes infectados por el VIH-SIDA y en inmunocomprometidos por otras causas, como los trasplantados. OBJECTIVE: to present the atypical case of a HIV-negative patient, deceased from Pneumocystis jirovecii more frequent in persons infected with the AIDS virus and in those underwent transplantation. DESCRIPTION: a patient with a history of alcoholism, asthma, respiratory symptoms and fever, HIV-negative, with a torpid course deceased at 11 days after admission. Lung: peripheral emphysema, scattered zones of a fleshy red appearance mixed with not much aired zones and impasted. INTERVENTION: a clinical necropsy was carried out where the direct cause of death was from Pneumocystis jirovecii, diagnosed using hematoxylin-esosin stain proving the presence of a characteristic foamy edema. In the silver methenamine stain it was possible to corroborate the presence of the microorganism. CONCLUSIONS: in this case the leading cause of death was Pneumocystis jirovecii pneumonia, an opportunistic pathogen frequently reported a cause of death in HIV-AIDS patients and also in those immunocompromised due to other causes, e.g. those with transplantation. Save   Related Articles

Pneumocystis jirovecii: cien a？os de historia Calderón Sandubete,Enrique; de Armas Rodríguez,Yaxsier; Capó de Paz,Virginia; Revista Cubana de Medicina Tropical , 2011, Abstract: introduction: pneumocystis jirovecii is one of the most important opportunistic pathogens affecting aids individuals and immunodepressive patients. in spite of the fact that it was observed one hundred years ago for the first time, many fundamental aspects of its biology and the morbidity it causes are still unknown. objective: this paper was aimed at presenting updating on the main aspects of the history, the epidemiology and the biology of p. jirovecii and the disease it causes. conclusions: a number of review articles have been published since the discovery, all of which provide details and novel elements of the microorganism. however, few original papers dealing with this problem have been found in the spanish literature. Save   Related Articles

Pneumocystis Jirovecii Pneumonia- Imaging findings in 19 patients Mahmoud Goudarzi Iranian Journal of Radiology , 2009, Abstract: Pneumocystis jirovecii pneumonia (PJP),formely called pneumocystis carinii pneumonia, is a serious disease in immunocompromised patients, particularly those with AIDS. However, many patients with this disease are unaware of their HIV serostatus, requiring early and prompt diagnosis of the disease. Early chest radiographic findings of PJP may be subtle or equivocal. On the other hand, advances in the treatment and prevention of the disease is associated with an increased rate of atypical manifestations, so it is important for radiologists to be familiar with the spectrum of imaging findings of the entity. The first report on imaging findings of PJP in a group of Iranian patients is presented. Save   Related Articles

Humoral Immune Responses to Pneumocystis jirovecii Antigens in HIV-Infected and Uninfected Young Children with Pneumocystis Pneumonia  [PDF] Kpandja Djawe, Kieran R. Daly, Linda Levin, Heather J. Zar, Peter D. Walzer PLOS ONE , 2013, DOI: 10.1371/journal.pone.0082783 Abstract: Background Humoral immune responses in human immunodeficiency virus (HIV)-infected and uninfected children with Pneumocystis pneumonia (PcP) are poorly understood. Methods Consecutive children hospitalized with acute pneumonia, tachypnea, and hypoxia in South Africa were investigated for PcP, which was diagnosed by real-time polymerase chain reaction on lower respiratory tract specimens. Serum antibody responses to recombinant fragments of the carboxyl terminus of Pneumocystis jirovecii major surface glycoprotein (MsgC) were analyzed. Results 149 children were enrolled of whom 96 (64%) were HIV-infected. PcP occurred in 69 (72%) of HIV-infected and 14 (26%) of HIV-uninfected children. HIV-infected children with PcP had significantly decreased IgG antibodies to MsgC compared to HIV-infected patients without PcP, but had similar IgM antibodies. In contrast, HIV-uninfected children with PcP showed no change in IgG antibodies to MsgC, but had significantly increased IgM antibodies compared to HIV-uninfected children without PCP. Age was an independent predictor of high IgG antibodies, whereas PcP was a predictor of low IgG antibodies and high IgM antibodies. IgG and IgM antibody levels to the most closely related MsgC fragments were predictors of survival from PcP. Conclusions Young HIV-infected children with PcP have significantly impaired humoral immune responses to MsgC, whereas HIV-uninfected children with PcP can develop active humoral immune responses. The children also exhibit a complex relationship between specific host factors and antibody levels to MsgC fragments that may be related to survival from PcP. Save   Related Articles

Pneumocystis jirovecii: cien a os de historia Pneumocystis jirovecii: one hundred years of history  [cached] Enrique Calderón Sandubete,Yaxsier de Armas Rodríguez,Virginia Capó de Paz Revista Cubana de Medicina Tropical , 2011, Abstract: Introducción: Pneumocystis jirovecii es uno de los patógenos oportunistas más importantes que afectan a individuos con síndrome de inmunodeficiencia adquirida y pacientes inmunodeprimidos por otras causas. A pesar de haber sido observado por primera vez hace más de 100 a os, se desconocen aún muchos aspectos importantes de su biología y de la morbilidad que produce. Objetivo: en este trabajo se pretende presentar una actualización sobre los principales aspectos de la historia, la epidemiología y la biología de P. jirovecii, así como de la enfermedad que produce. Conclusiones: se han publicado varios artículos de revisión desde su descubrimiento que brindan detalles y elementos novedosos del microorganismo, sin embargo, pocos son los manuscritos encontrados en la literatura de habla hispana que aborden esta problemática. Introduction: Pneumocystis jirovecii is one of the most important opportunistic pathogens affecting AIDS individuals and immunodepressive patients. In spite of the fact that it was observed one hundred years ago for the first time, many fundamental aspects of its biology and the morbidity it causes are still unknown. Objective: this paper was aimed at presenting updating on the main aspects of the history, the epidemiology and the biology of P. jirovecii and the disease it causes. Conclusions: a number of review articles have been published since the discovery, all of which provide details and novel elements of the microorganism. However, few original papers dealing with this problem have been found in the Spanish literature. Save   Related Articles

Nonadherence to Primary Prophylaxis against Pneumocystis jirovecii Pneumonia  [PDF] James D. Heffelfinger, Andrew C. Voetsch, Glenn V. Nakamura, Patrick S. Sullivan, A. D. McNaghten, Laurence Huang PLOS ONE , 2009, DOI: 10.1371/journal.pone.0005002 Abstract: Background Despite the effectiveness of prophylaxis, Pneumocystis jirovecii pneumonia (PCP) continues to be the most common serious opportunistic infection among HIV-infected persons. We describe factors associated with nonadherence to primary PCP prophylaxis. Methodology/Principal Findings We used 2000–2004 data from the Supplement to HIV/AIDS Surveillance (SHAS) project, a cross-sectional interview project of HIV-infected persons ≥18 years conducted in 18 states. We limited the analysis to persons who denied having prior PCP, reported having a current prescription to prevent PCP, and answered the question “In the past 30 days, how often were you able to take the PCP medication(s) exactly the way your doctor told you to take them?” We used multivariable logistic regression to describe factors associated with nonadherence. Of 1,666 subjects prescribed PCP prophylaxis, 305 (18.3%) were nonadherent. Persons were more likely to be nonadherent if they reported using marijuana (adjusted odds ratio [aOR] = 1.6, 95% confidence interval [CI] = 1.1–2.4), non-injection drugs other than marijuana (aOR = 1.5, 95% CI = 1.0–2.1), or injection drugs (aOR = 2.3, 95% CI = 1.3–4.1) in the past year; their mental health was “not good” for ≥1 day during the past month (aOR = 1.6, 95% CI = 1.2–2.2); their most recent CD4 count was <200 cells/μL (aOR = 1.6, 95% CI = 1.1–2.2); or taking ART usually (aOR = 9.6, 95% CI = 6.7–13.7) or sometimes/rarely/never (aOR = 18.4, 95% CI = 11.1–30.4), compared with always, as prescribed. Conclusion/Significance Providers should inquire about and promote strategies to improve adherence to PCP prophylaxis, particularly among persons who use illicit drugs, have mental health issues, and who are not compliant with ART to reduce the occurrence of PCP. Save   Related Articles

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