Coexistência de infeções oportunistas pulmonares num doente com infeção por vírus da imunodeficiência humana e uma forma persistente de pneumonia por Pneumocystis jirovecii: caso clínico

Bento, Diogo; Esteves, Francisco; Matos, Olga; Miranda, Ana Cláudia Carvalho de; Ventura, Fernando; Araújo, Carlos; Kamal, Mehnaz

doi:10.1016/j.rppneu.2013.01.005

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…Several polymorphisms are regarded as highly informative markers for comparative analyses between the given genotype and a specific clinical or epidemiological data. For instance, it has been reported that SNP at the 85 position of the P. jirovecii mitochondrial large-subunit rRNA ( mtLSU rRNA ) gene, involved in basic mechanisms during translation, is useful to detect intraspecific differences between populations (Beard et al 2000 ), whereas mutations in dihydropteroate synthase ( DHPS ) gene, presumably resulting from previous exposure to sulfa drug prophylaxis, have been linked to drug resistance and failure of anti-PcP treatment (Bento et al 2013 ). In turn, data obtained during studies on mutations in the gene encoding DHFR enzyme from folic acid pathway demonstrate that five out of the six mutations conserved among unrelated species are located within the presumed active site of the enzyme.…”

Section: Genetic Diversitymentioning

confidence: 99%

Pneumocystis jirovecii—from a commensal to pathogen: clinical and diagnostic review

et al. 2015

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Pneumocystis pneumonia is an opportunistic disease caused by invasion of unicellular fungus Pneumocystis jirovecii. Initially, it was responsible for majority of morbidity and mortality cases among HIV-infected patients, which later have been reduced due to the introduction of anti-retroviral therapy, as well as anti-Pneumocystis prophylaxis among these patients. Pneumocystis pneumonia, however, is still a significant cause of mortality among HIV-negative patients being under immunosuppression caused by different factors, such as transplant recipients as well as oncologically treated ones. The issue of pneumocystosis among these people is particularly emphasized in the article, since rapid onset and fast progression of severe symptoms result in high mortality rate among these patients, who thereby represent the group of highest risk of developing Pneumocystis pneumonia. In contrast, fungal invasion in immunocompetent people usually leads to asymptomatic colonization, which frequent incidence among healthy infants has even suggested the possibility of its association with sudden unexpected infant death syndrome. In the face of emerging strains with different epidemiological profiles resulting from genetic diversity, including drug-resistant genotypes, the colonization phenomenon desires particular attention, discussed in this article. We also summarize specific and sensitive methods, required for detection of Pneumocystis invasion and for distinguish colonization from the disease.

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Section: Genetic Diversitymentioning

confidence: 99%

Pneumocystis jirovecii—from a commensal to pathogen: clinical and diagnostic review

et al. 2015

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Diversity and combinations of infectious agents in 38 adults with an infection-triggered reactive haemophagocytic syndrome: a multicenter study

Lerolle

Laanani

Rivière

et al. 2016

Clinical Microbiology and Infection

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Reactive haemophagocytic syndrome (HS) is a rare condition that occurs in patients with infections, haematological malignancies or autoimmune diseases. Although various microorganisms are thought to trigger HS, most of the literature data on this topic have been gathered in single-centre case series. Here, we sought to characterize infectious triggers in a large, multicentre cohort of patients with HS. Patients were included in the present study if HS was solely due to one or more infections. Detailed microbiological data were recorded. Of the 162 patients with HS in the cohort, 40 (25%) had at least one infection and 38 of the latter (including 14 women, 36.8%) were included. The median age was 46 years. Seven patients were presumed to be immunocompetent (18.4%), whereas 19 patients (50%) were infected with human immunodeficiency virus and 12 patients (31.6%) were immunocompromised for other reasons. Twenty-seven patients (71.1%) had a single infection, whereas six (15.8%) and five (13.1%) patients had, respectively, two and three concomitant infections. We observed pyogenic bacterial infections (n = 7), tuberculosis (n = 10), non-tuberculous mycobacteriosis (n = 3), viral infections (n = 17: 11 cytomegalovirus, three Epstein-Barr virus, two human herpesvirus 8, one herpes simplex virus 2), parasitic infections (n = 8: four disseminated toxoplasmosis, one leishmaniasis, three malaria), fungal infections (n = 5: four pulmonary pneumocystosis and one candidaemia). Eighteen patients (47.4%) received corticosteroids and/or etoposide. Twelve patients died (31.6%). All multiple infections and all deaths occurred in immunocompromised patients. When compared with patients suffering from malignancy-associated HS, patients with infection-triggered HS were younger and more likely to be immunocompromised, and had a better outcome.

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Cystic lung lesions revealing a Pneumocystis jirovecii and Aspergillus flavus co-infection in an HIV-infected patient

Langlois

Lorillou

Ferry

et al. 2015

International Journal of Infectious Diseases

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Coexistência de infeções oportunistas pulmonares num doente com infeção por vírus da imunodeficiência humana e uma forma persistente de pneumonia por Pneumocystis jirovecii: caso clínico

Cited by 4 publications

References 19 publications

Pneumocystis jirovecii—from a commensal to pathogen: clinical and diagnostic review

Pneumocystis jirovecii—from a commensal to pathogen: clinical and diagnostic review

Diversity and combinations of infectious agents in 38 adults with an infection-triggered reactive haemophagocytic syndrome: a multicenter study

Cystic lung lesions revealing a Pneumocystis jirovecii and Aspergillus flavus co-infection in an HIV-infected patient

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