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Pneumocystis carinii
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
Peter D. Walzer, C. Kurtis Kim, Melanie T. Cushion
In the advanced diffuse form of pneumocystosis, all lobes of the lungs are involved by the disease process. The lungs are bulky and densely consolidated with a rubbery consistency. The cut surfaces are yellowish grey to reddish grey, granular, and dry with obliteration of the air spaces. Overall, the changes are similar to those found with diffuse alveolar damage caused by a variety of etiologies, which are manifested clinically as the adult respiratory distress syndrome. In less severely infected areas, foci of consolidation, atelectasis, and compensatory hyperinflation are intermixed. In the epidemic infantile form of pneumocystosis (interstitial plasma cell pneumonia), dark red liverlike lungs are seen in those who died rapidly (11).
Pneumocystis
Published in Mahmoud A. Ghannoum, John R. Perfect, Antifungal Therapy, 2019
The hallmark histological finding in pneumocystosis is formation of a foamy, eosinophilic exudate within the lung alveoli (Figure 22.2). Microscopically, alveolar-capillary leakage and type 1 pneumocyte destruction have been noted, along with intra-alveolar transudate containing macrophages and a very few neutrophilic granulocytes, dilated capillary tubes, edema, and thickened alveolar septae [43–45].
In silico molecular docking for assessing anti-fungal competency of hydroxychavicol, a phenolic compound of betel leaf (Piper betle L.) against COVID-19 associated maiming mycotic infections
Published in Drug Development and Industrial Pharmacy, 2022
Vinusri Sekar, Gnanam Ramasamy, Caroline Ravikumar
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus, Severe Acute Respiratory Syndrome Corona Virus-2 (SARS CoV-2) and as of June 2021 according to WHO report [1] there have been 179,686,071 confirmed cases of COVID-19, including 3,899,172 deaths. A substantial increase of fungal infections (e.g. Candidiasis, Aspergillosis, Cryptococcosis, Pneumocystosis, Histoplasmosis) has been detected in individuals with active infection caused by the severe flu viruses, human immunodeficiency virus (HIV), and COVID-19 [2,3]. In COVID-19 patients, the infection of SARS CoV-2 causes mild respiratory infection with severe inflammation and impairment of the immune system with reduction in the levels of CD 4+ T cells and CD8+ T cells [4], leads to the opportunistic incidence of fungal co-infections, especially for the severely ill or immune suppressed patients at the middle or at the post covid stage [5].
Risk of invasive fungal infections among patients treated with disease modifying treatments for multiple sclerosis: a comprehensive review
Published in Expert Opinion on Drug Safety, 2021
R. Scotto, A. Reia, A.R. Buonomo, M. Moccia, G. Viceconte, E. Pisano, E. Zappulo, V. Brescia Morra, I. Gentile
Rituximab was the first monoclonal antibody used as DMT in patients with MS. Interestingly, while no fungal infections were recorded in clinical trials among patients treated with Rituximab for RRMS, cases of IFI were reported from observational studies. In particular, one case of pulmonary aspergillosis and one case of invasive candidiasis were reported [16,17], together with a case of pulmonary pneumocystosis [16]. The rate of fungal infections occurrence among patients treated with rituximab was low. In fact, only one study reported an occurrence rate of 3.4% [17]. Nevertheless, the occurrence of these infections must raise the attention of clinicians, especially considering the absence of other risk factors for opportunistic infections reported in the cited studies. Similarly, patients treated with Alemtuzumab and enrolled in observational studies showed sporadic occurrence of fungal infections. Two authors indeed reported a case of pulmonary aspergillosis, with an overall occurrence rate for fungal infections of 4.5% and 2.3%, respectively [17,33]. On the other hand, among 1082 patients treated with Alemtuzumab in randomized clinical trials, only one case of esophageal candidiasis was recorded [27]. Among studies on efficacy and safety of Natalizumab, only one prospective observational study reported the occurrence of fungal infections with a rate of <0.1% (5/6434 patients), with 4 cases of invasive infections (one, aspergilloma, one candida pneumonia, one cryptococcal fungemia and one cryptococcal meningitis) [70].
Biotherapies-induced neutropenia in autoimmune and auto-inflammatory disorders and other orphan diseases
Published in Expert Opinion on Orphan Drugs, 2019
Emmanuel Andrès, Noel Lorenzo Villalba, Abrar-Ahmad Zulfiqar, Khalid Serraj, Jacques-Eric Gottenberg
The impact of immune impairment in autoimmune and auto-inflammatory disorders on infection risk is not fully understood. At present, the only recommended preventive measures consist of hepatitis B and C vaccination, a Listeria-free diet, tuberculosis screening and prophylaxis, annual papillomavirus screening for all biotherapies, and anti-herpetic prophylaxis for alemtuzumab [15,35–40]. Given the non-negligible risk of unpredicted infective events, Buonomo et al. advised physicians to take into account patients’ history of infectious diseases and vaccine status and to consider supplementary prophylactic strategies, including screening for Toxoplasma gondii and viral hepatitis serological status, as well as pre-emptive approaches to avert both CMV reactivation and pneumocystosis [46]. This antibiotic prophylaxis (with cotrimoxazole in case of pneumocystosis prevention) is only recommended with alemtuzumab therapy.