Disseminated Pneumocystis jirovecii Infection with Osteomyelitis in a Patient with CTLA-4 Haploinsufficiency

Siddiqi, Aminaa; Liu, Anne Y.; Charville, Gregory W.; Kunder, Christian A.; Uzel, Gülbû; Akha, Amir A. Sadighi; Oak, Jean; Martin, Beth A.; Sacha, Joshua J.; Lewis, David B.; Gernez, Yaël

doi:10.1007/s10875-020-00748-z

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…In some early studies, primary immunodeficiency constitutes the most frequent underlying diseases associated with PCP in infants [ 164 ]. We provided a comprehensive list of primary immunodeficient diseases associated with PCP ( Table 2 and Table S2 [ 86 , 165 , 166 , 167 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 , 180 , 181 , 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 , 190 , 191 , 192 , 193 , 194 , 195 , 196 , 197 , 198 , 199 , 200 , 201 , 202 , 203 , 204 , 205 , 206 , 207 , 208 , 209 , 210 , 211 , 212 , 213 , 214 ,…”

Section: Immunodeficient Conditions and Risk Factors For Pcpmentioning

confidence: 99%

Trends in the Epidemiology of Pneumocystis Pneumonia in Immunocompromised Patients without HIV Infection

Xue,

Kong,

2023

JoF

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The increasing morbidity and mortality of life-threatening Pneumocystis pneumonia (PCP) in immunocompromised people poses a global concern, prompting the World Health Organization to list it as one of the 19 priority invasive fungal diseases, calling for increased research and public health action. In response to this initiative, we provide this review on the epidemiology of PCP in non-HIV patients with various immunodeficient conditions, including the use of immunosuppressive agents, cancer therapies, solid organ and stem cell transplantation, autoimmune and inflammatory diseases, inherited or primary immunodeficiencies, and COVID-19. Special attention is given to the molecular epidemiology of PCP outbreaks in solid organ transplant recipients; the risk of PCP associated with the increasing use of immunodepleting monoclonal antibodies and a wide range of genetic defects causing primary immunodeficiency; the trend of concurrent infection of PCP in COVID-19; the prevalence of colonization; and the rising evidence supporting de novo infection rather than reactivation of latent infection in the pathogenesis of PCP. Additionally, we provide a concise discussion of the varying effects of different immunodeficient conditions on distinct components of the immune system. The objective of this review is to increase awareness and knowledge of PCP in non-HIV patients, thereby improving the early identification and treatment of patients susceptible to PCP.

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Section: Immunodeficient Conditions and Risk Factors For Pcpmentioning

confidence: 99%

Trends in the Epidemiology of Pneumocystis Pneumonia in Immunocompromised Patients without HIV Infection

Xue,

Kong,

2023

JoF

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“…Because PJP is one of the most frequent opportunistic infections, physicians should consider it when an HIV-infected patient or a patient who is immunosuppressed for reasons other than HIV complains of fever, shortness of breath, and/or cough ( 8 , 9 ). In more than 95% of cases, P. jirovecii infection is restricted to the lung, but in severely immunocompromised individuals, the rare disseminated infection (thyroid, kidney, bone marrow, liver, spleen, retina, ear, and skin) may occur ( 10 – 14 ). The major problem in Pneumocystis research is the absence of an in vitro culture system ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

The mycological and molecular study of Pneumocystis jiroveci pneumonia among HIV and non-HIV immunocompromised patients hospitalized in pulmonary units in Guilan, Northern Iran

Rafat

Ashrafi

Hashemi

et al. 2021

IJM

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Background and Objectives: Pneumocystis jirovecii pneumonia (PJP) is a serious infection that usually affects those with a weak immune system. Since the prevalence of this infection in Iran and in the world is not clearly defined, the present study aimed to evaluate the incidence, clinical spectrum, and demographic characteristics of PJP among HIV and non-HIV immunocompromised patients. Materials and Methods: Bronchoalveolar Lavage (BAL) specimens were obtained from 3 groups of immunocompromised patients, including acquired immunodeficiency syndrome (AIDS) patients, diabetic patients, and patients receiving immuno- suppressive therapies. All were hospitalized in pulmonary units. The specimens were examined using microscopic methods (Giemsa and calcofluor white staining) and the nested-PCR technique based on mtLSU-rRNA gene. Results: A total of 120 BAL samples were collected. From 12.5% (5 from 40) of HIV-infected patients, 5% (2 from 40) of patients receiving immunosuppressive therapies, and 2.5% (1 from 40) of diabetic patients Pneumocystis jiroveci was iso- lated. There was not any association between the prevalence of PJP and the patient's gender (p= 0.557) and age (p= 0.681). Fever and dyspnea (n=7, 87.5%), nonproductive cough and abnormal auscultation sound (n=5, 62.5%), and also chills and weight loss (n=2, 25%) were the documented clinical symptoms of PJP. Also, the results showed that none of the samples had positive results for P. jiroveci with microscopic tests while using the nested-PCR method 8 samples had positive results. Conclusion: Since PJP often causes symptoms that are similar to other illnesses, such as the flu or tuberculosis, clinical and laboratory findings should be used simultaneously for making the final decision on drug administration.

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Extrapulmonary Pneumocystis jirovecii Infection in an Immunocompromised Patient With Concomitant Cytomegalovirus Reactivation: A Case Report and Literature Review

Fabiani

Amadori²,

Tiseo

et al. 2022

Infect Dis Clin Pract

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Pneumocystis jirovecii is commonly associated with a potentially fatal pneumonia in acquired immune deficiency syndrome patients, but its spread outside lungs is uncommon and poses a diagnostic challenge. Clinical awareness is therefore needed to start promptly adequate therapy. In this review, we report the case of an acquired immune deficiency syndrome patient with rapidly progressive disseminated pneumocystosis and subsequently analyze 189 other cases of extrapulmonary pneumocystosis described in literature. The most common extrapulmonary sites of Pneumocystosis jirovecii infection were spleen, lymph nodes, liver, kidneys, and eyes; clinical manifestations, which may occur either with or without lung involvement, ranged from asymptomatic incidental findings to a multifaceted disease with multisystem involvement. Human immunodeficiency virus (HIV) infection was documented in the majority of cases (91.6%), and concurrent or subsequent immunodeficiency-related conditions other than Pneumocystosis jirovecii were reported in 63.4% of patients, with cytomegalovirus (CMV) infection as the most common. In conclusion, disseminated pneumocystosis is a rare, little-known, but life-threatening opportunistic infection that must be taken into account, together with other immunodeficiency-related conditions such as Cytomegalovirus infection, to draw up an adequate diagnostic algorithm, establish a timely diagnosis, and ensure proper treatment.

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Disseminated Pneumocystis jirovecii Infection with Osteomyelitis in a Patient with CTLA-4 Haploinsufficiency

Cited by 4 publications

References 5 publications

Trends in the Epidemiology of Pneumocystis Pneumonia in Immunocompromised Patients without HIV Infection

Trends in the Epidemiology of Pneumocystis Pneumonia in Immunocompromised Patients without HIV Infection

The mycological and molecular study of Pneumocystis jiroveci pneumonia among HIV and non-HIV immunocompromised patients hospitalized in pulmonary units in Guilan, Northern Iran

Extrapulmonary Pneumocystis jirovecii Infection in an Immunocompromised Patient With Concomitant Cytomegalovirus Reactivation: A Case Report and Literature Review

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