Pneumocystosis

Source: Wikipedia, the free encyclopedia.
Pneumocystosis
Other namesPneumocystis jiroveci pneumonia,
Infectious diseases[1]
Symptoms
Complications
Types
Causes
immunofluorescence assay, biopsy[2]
PreventionTrimethoprim/sulfamethoxazole (co-trimoxazole) in high risk groups[7]
MedicationTrimethoprim/sulfamethoxazole (co-trimoxazole)[4]
FrequencyUncommon,[4] 97% in lungs[7]

Pneumocystosis is a

ear canals or underarms.[3]

It is caused by Pneumocystis jirovecii, a fungus which is usually breathed in and found in the lungs of healthy people without causing disease, until the person's immune system becomes weakened.[7]

Diagnosis is by identifying the organism from a sample of fluid from affected lungs or a biopsy.[3][4] Prevention in high risk people, and treatment in those affected is usually with trimethoprim/sulfamethoxazole (co-trimoxazole).[4][8]

The prevalence is unknown.

Second World War.[9]

Signs and symptoms

Pneumocystosis is generally an infection in the lungs.

Lungs

When the lungs are affected there is usually a dry

difficulty breathing and fever, usually present for longer than four weeks.[2][7] There may be chest pain, shivering or tiredness.[8] The oxygen saturation is low.[2] The lungs may fail to function.[4]

Eyes

Pneumocystosis in eyes may appear as a single or multiple (up to 50) yellow-white plaques in the eye's choroid layer or just beneath the retina.[12] Vision is usually not affected and it is typically found by chance.[12]

Skin

If occurring in the skin, pneumocystosis most often presents as

mastoid bone.[6] The nerves in the head may be affected.[6]

Cause

Pneumocystosis is caused by Pneumocystis jirovecii, a fungus which is generally found in the lungs of healthy people, without causing disease until the person's immune system becomes weakened.[7]

Risk factors

Pneumocystosis occurs predominantly in people with HIV/AIDS.

corticosteroids.[8]

Diagnosis

X-ray and CT of ground glass opacities and pneumothorax in pneumocystis pneumonia

Diagnosis of Pneumocystis pneumonia is by identifying the organism from a sample of

direct immunofluorescence of infected cells.[3]

Diagnosis in the eye involves

fundoscopy.[12] A biopsy of the retina and choroid layer may be performed.[12] In affected liver, biopsy shows focal areas of necrosis and sinusoidal widening.[10] H&E staining show extracellular frothy pink material.[10] Typical cysts with a solid dark dot can be seen using a Grocott silver stain.[10]

Differential diagnosis

Pneumocystosis may appear similar to

adult respiratory distress syndrome.[2] Other infections can present similarly such as tuberculosis, Legionella, and severe flu.[2]

Prevention

There is no vaccine that prevents pneumocystosis.[8] Trimethoprim/sulfamethoxazole (co-trimoxazole) might be prescribed for people at high risk.[8]

Treatment

Treatment is usually with co-trimoxazole.[4][8] Other options include pentamidine, dapsone and atovaquone.[2]

Outcomes

It is fatal in 10-20% of people with HIV/AIDS.[3] Pneumocystosis in people without HIV/AIDS is frequently diagnosed late and the death rate is therefore higher; 30-50%.[3]

Epidemiology

The exact number of people in the world affected is not known.[7] Pneumocystosis affects lungs in around 97% of cases and is often fatal without treatment.[7]

History

The first cases of pneumocystosis affecting lungs were described in premature infants in Europe following the

Second World War.[9] It was then known as plasma cellular interstitial pneumonitis of the newborn.[9]

Pneumocystis jirovecii (previously called Pneumocystis carinii) is named for Otto Jírovec, who first described it in 1952.[2]

References

  1. ^ a b c d "ICD-11 - ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Retrieved 30 June 2021.
  2. ^ .
  3. ^ a b c d e f g h i j "Pneumocystosis | DermNet NZ". dermnetnz.org. Archived from the original on 24 July 2021. Retrieved 24 July 2021.
  4. ^ a b c d e f g h i j k l "Orphanet: Pneumocystosis". www.orpha.net. Archived from the original on 24 July 2021. Retrieved 24 July 2021.
  5. ^ .
  6. ^ .
  7. ^ a b c d e f g h i j k l m n o "CDC - DPDx - Pneumocystis". www.cdc.gov. 22 January 2019. Archived from the original on 25 July 2021. Retrieved 25 July 2021.
  8. ^ a b c d e f g "Pneumocystis pneumonia | Fungal Diseases | CDC". www.cdc.gov. 1 December 2020. Archived from the original on 26 July 2021. Retrieved 26 July 2021.
  9. ^
    PMID 20736243
    .
  10. ^ .
  11. .
  12. ^ .
  13. .