China
Africa
Explore chapters and articles related to this topic
Infectious disease
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Pneumocystis jirovecii (formally known as Pneumocystis carinii) is a fungus which causes pneumonia (pneumocystis pneumonia or PCP): dry cough, dyspnoea and fever but with few signs on examination of the chest. Patients may be hypoxic, particularly after exercise. Diagnosis: can be made following staining of a bronchoalveolar lavage. Treatment: co-trimoxazole, clindamycin/primaquine or pentamidine. Steroids are given in severe illnesses when patients are hypoxic.
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
Pneumocystis carinii pneumonia should be considered in any compromised host who develops fever, respiratory symptoms, or infiltrates on chest X-ray. These clinical features can be mimicked by a long list of other infectious agents including gram-positive and gram-negative bacteria, legionella, mycobacteria, fungi, viruses, parasites, mycoplasmas, and chlamydia. A similar clinical picture can be caused by noninfectious etiologies including tumor, hemorrhage, edema, fibrosis, oxygen, radiation, and drugs. The frequence of occurrence of P. carinii in AIDS and its subtle and varied presentation have raised medical interest in the clinical manifestations of this organism. Patients with HIV infection frequently develop fever and a variety of other prodromal symptoms for weeks to months before developing pneumocystosis as the first manifestation of AIDS. Whether these clinical symptoms are all due to P. carinii is as yet unclear.
The Lymphatic/Immune System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Infection with human immunodeficiency virus (HIV) presents special problems. HIV is a retrovirus that preferentially attacks the T-helper lymphocytes, entering the host cell by attaching at the CD4' site. By reproducing within the T-lymphocytes, HIV kills the host cell and destroys the host's immune response. HIV infection may be asymptomatic, or it may progress to minor or severe immunodeficiency. The severe form is acquired immune deficiency syndrome (AIDS), from which fatality may result because of opportunistic infections. Among the more prominent of the HIV opportunistic infections are Pneumocystis carinii pneumonia, Cytomegalovirus pneumonia, candidiasis, toxoplasmosis, and Herpesvirus infections.
The quest for an HIV-1 vaccine: will mRNA deliver us from evil?
Published in Expert Review of Vaccines, 2023
Forty-two years have gone by since the first report of five unusual cases of Pneumocystis carinii pneumonia in previously healthy young men in Los Angeles [1], which heralded the official appearance of AIDS on the world stage, but the quest for an HIV-1 vaccine is still on. The obstacles have been enormous. HIV-1 remains unrivaled in its extraordinary armamentarium of immune-evasive tactics, spanning from antigenic variation to glycan-mediated shielding to conformational camouflage. Most importantly, the bar to achieve protection from HIV/AIDS is extremely high because, in the case of HIV-1, protection equals ‘sterilizing’ immunity. The reason is that, as a retrovirus, HIV-1 integrates its genome into the host DNA where it can survive indefinitely, outside the reach of current therapeutic strategies. For most other infectious agents, the major goal of a vaccine is prevention of the acute illness that occurs during primary infection. For HIV-1 this objective is of no relevance to protection because the real disease is caused by a progressive corruption of the adaptive immune system that occurs over the course of several years of chronic infection. Once the virus gets its foot in the door, the clock starts. And the disease will almost invariably progress unless antiretroviral treatment is initiated and continued indefinitely. Thus, the sole way to immunize against HIV-1 disease is to lock the virus out of the body from square one: ‘sterilizing’ immunity.
Diagnostic value of metagenomic next-generation sequencing of lower respiratory tract specimen for the diagnosis of suspected Pneumocystis jirovecii pneumonia
Published in Annals of Medicine, 2023
Yang Liu, Xiaoning Wang, Jun Xu, Qiwen Yang, Huadong Zhu, Jing Yang
Pneumocystis jirovecii pneumonia (PCP), an opportunistic pulmonary infection caused by Pneumocystis jirovecii (P. jirovecii), has become a threat not only to HIV-infected population, but also to large numbers of HIV-negative immunosuppressed patients due to increasing use of corticosteroids, chemotherapy and other immunosuppressants [1]. While the mortality of HIV-positive PCP has decreased to less than 20%, PCP in HIV-negative patients is still of great concern with high mortality rates of 30–60% [2]. Early diagnosis and timely treatment are important in improving prognosis. However, the clinical manifestations of PCP are sometimes atypical, but rapidly progressive, which may lead to delayed initiation of anti-PCP therapy and unfavorable outcomes. Therefore, diagnostic tools with high sensitivity and specificity have always been pursued by clinicians.
The efficacy and safety of reduced-dose sulfamethoxazole-trimethoprim for chemoprophylaxis of Pneumocystis pneumonia in patients with rheumatic diseases
Published in Modern Rheumatology, 2021
Tomoya Harada, Ryohei Kato, Yuriko Sueda, Yoshihiro Funaki, Miki Takata, Ryota Okazaki, Yasuyuki Hasegawa, Akira Yamasaki
Pneumocystis pneumonia (PCP) is a potentially life-threatening opportunistic infection caused by Pneumocystis jirovecii in compromised patients such as individuals with human immunodeficiency virus (HIV) infection and patients under immunosuppressive therapy [1–3]. An infectious disease is an important prognostic factor in rheumatic disease. Pneumocystis pneumonia occurs in HIV-positive patients, and it is one of the most common opportunistic infections in the absence of prophylaxis [4]. Its incidence is 5–15% in patients with solid organ transplantation [5] and 2%–4% in patients with rheumatic diseases [6,7]. The mortality rate of PCP associated with rheumatic disease is higher than the rate associated with HIV-positive patients [7–10]; therefore, preventing PCP in patients with rheumatic disease is important.