Pneumocystis Jirovecii Pneumonia, previously known as Pneumocystis Carinii Pneumonia, is a fungal illness that most frequently affects immunocompromised individuals which can be fatal in extreme cases. Patients with underlying condition which significantly compromise immunity are at risk. Conditions such as AIDS, or cancer substantially add to the risk, and Patients with underlying condition which significantly compromise immunity are at risk.
Conditions such as AIDS, or cancer substantially add to the risk, and transplant patients also experience severe symptoms. Any other illnesses which are treated with immunosuppressive medication could also result in a fatal outcome when infected with Pneumocystis jirovecii pneumonia. Individuals affected with PCP may develop symptoms such cough, dyspnea, fever, and in extreme cases may experience respiratory failure. It is suspected that pneumocystis is transmitted from human to human through the air.
Asymptomatic lung colonization can occur in persons with healthy immune systems, and these individuals may unwittingly serve as reservoirs for the transmission of Pneumocystis to immunocompromised hosts. Although it is still the most prevalent and severe opportunistic respiratory infection in individuals with AIDS, the prevalence of infection in this population has decreased significantly due to the widespread use of antiretroviral and prophylaxis therapy.
Epidemiology
Pneumocystis originally surfaced in Europe in malnourished newborns in institutions after World War II. Prior to the HIV epidemic in the 1980s, little was understood about the organism, and as a result, research into this illness experienced a sudden urge because of AIDS. Pneumocystis jirovecii Pneumonia is now a known illness around the world.
Although it is commonly observed in individuals with a compromised immunity, it has now been observed infrequently in those with fully functional and healthy immune systems. Patients in certain immunocompromised conditions are extremely susceptible to PCP.
These include:
Individuals with cancer (particularly hematologic cancers)
Patients being treated for certain rheumatologic or inflammatory conditions
Patients who have undergone solid organ or hematopoietic cell transplants
Patients with any condition which causes defects in cell-mediated immunity
The combination of immunosuppressive therapy with the intake of glucocorticoids is the greatest risk factor for PCP among patients who aren’t infected with HIV. During the beginning of the HIV epidemic, almost 20% of individuals whose CD4+ levels were below 200 cells/microL were observed with PCP.
But, since 1989, PCP rates began to fall at the rate of 3.4% each year between 1992 and 1995, because of the use of antiretroviral and primary prophylaxis therapy. Between 1996 and 1998, the infection rates fell by 21.5% per year. Despite the fall in infection rates in the US and other industrialized nations, this infection is still the major cause of severe illness in immunocompromised patients.
Anatomy
Pathophysiology
Pneumocystis jirovecii typically infects the lungs of immunocompromised individuals. Pneumocystis binds to Type I alveolar epithelium, allowing it to convert from its small trophic form to its bigger cystic form, as revealed by microscopic investigation.
Pneumocystis adhesion to alveoli is not the sole cause of diffuse alveolar damage; rather, the host’s inflammatory response leads to impaired exchange of gases and severe lung damage, which causes hypoxia and potentially respiratory failure.
This infection is primarily an infection of the alveoli, however the rare, disseminated form may be observed in immunocompromised individuals.
Etiology
In 1988, Pneumocystis was recognized as an ascomycetous fungus. Previously, it was assumed that Pneumocystis belonged to the protozoan class. It was believed that its life cycle resembled the lifecycle of a fungus as well as a protozoan. Eventually, disagreement over its precise categorization prompted additional research.
Through meticulous phylogenetic analysis of small subunit ribosomal RNAs, scientists have been able to compare the lineages of plants, animals, fungi, and protozoa.
On the basis of the structure of important enzymes, gene sequencing, and cell wall composition, researchers have ascertained that Pneumocystis is a member of the fungus family. The Pneumocystis genus has numerous species, including P. jirovecii and P. carinii, which, respectively, infect rats and humans.
Genetics
Prognostic Factors
PCP can be a fatal condition if not treated early. Moderate to severe cases of PCP can benefit vastly from corticosteroids. This can significantly improve the prognosis and decrease the incidence of death.
Not indicated for children less than 13 years
For more than 13 years as prophylaxis, 1500 mg orally once daily with food
Mild-to-Moderate Pneumocystis jirovecii Pneumonia
Not indicated for children less than 13 years
For more than 13 years, 750mg/5ml twice daily taken with food for 21 days
Pneumocystis Jirovecii Pneumonia, previously known as Pneumocystis Carinii Pneumonia, is a fungal illness that most frequently affects immunocompromised individuals which can be fatal in extreme cases. Patients with underlying condition which significantly compromise immunity are at risk. Conditions such as AIDS, or cancer substantially add to the risk, and Patients with underlying condition which significantly compromise immunity are at risk.
Conditions such as AIDS, or cancer substantially add to the risk, and transplant patients also experience severe symptoms. Any other illnesses which are treated with immunosuppressive medication could also result in a fatal outcome when infected with Pneumocystis jirovecii pneumonia. Individuals affected with PCP may develop symptoms such cough, dyspnea, fever, and in extreme cases may experience respiratory failure. It is suspected that pneumocystis is transmitted from human to human through the air.
Asymptomatic lung colonization can occur in persons with healthy immune systems, and these individuals may unwittingly serve as reservoirs for the transmission of Pneumocystis to immunocompromised hosts. Although it is still the most prevalent and severe opportunistic respiratory infection in individuals with AIDS, the prevalence of infection in this population has decreased significantly due to the widespread use of antiretroviral and prophylaxis therapy.
Pneumocystis originally surfaced in Europe in malnourished newborns in institutions after World War II. Prior to the HIV epidemic in the 1980s, little was understood about the organism, and as a result, research into this illness experienced a sudden urge because of AIDS. Pneumocystis jirovecii Pneumonia is now a known illness around the world.
Although it is commonly observed in individuals with a compromised immunity, it has now been observed infrequently in those with fully functional and healthy immune systems. Patients in certain immunocompromised conditions are extremely susceptible to PCP.
These include:
Individuals with cancer (particularly hematologic cancers)
Patients being treated for certain rheumatologic or inflammatory conditions
Patients who have undergone solid organ or hematopoietic cell transplants
Patients with any condition which causes defects in cell-mediated immunity
The combination of immunosuppressive therapy with the intake of glucocorticoids is the greatest risk factor for PCP among patients who aren’t infected with HIV. During the beginning of the HIV epidemic, almost 20% of individuals whose CD4+ levels were below 200 cells/microL were observed with PCP.
But, since 1989, PCP rates began to fall at the rate of 3.4% each year between 1992 and 1995, because of the use of antiretroviral and primary prophylaxis therapy. Between 1996 and 1998, the infection rates fell by 21.5% per year. Despite the fall in infection rates in the US and other industrialized nations, this infection is still the major cause of severe illness in immunocompromised patients.
Pneumocystis jirovecii typically infects the lungs of immunocompromised individuals. Pneumocystis binds to Type I alveolar epithelium, allowing it to convert from its small trophic form to its bigger cystic form, as revealed by microscopic investigation.
Pneumocystis adhesion to alveoli is not the sole cause of diffuse alveolar damage; rather, the host’s inflammatory response leads to impaired exchange of gases and severe lung damage, which causes hypoxia and potentially respiratory failure.
This infection is primarily an infection of the alveoli, however the rare, disseminated form may be observed in immunocompromised individuals.
In 1988, Pneumocystis was recognized as an ascomycetous fungus. Previously, it was assumed that Pneumocystis belonged to the protozoan class. It was believed that its life cycle resembled the lifecycle of a fungus as well as a protozoan. Eventually, disagreement over its precise categorization prompted additional research.
Through meticulous phylogenetic analysis of small subunit ribosomal RNAs, scientists have been able to compare the lineages of plants, animals, fungi, and protozoa.
On the basis of the structure of important enzymes, gene sequencing, and cell wall composition, researchers have ascertained that Pneumocystis is a member of the fungus family. The Pneumocystis genus has numerous species, including P. jirovecii and P. carinii, which, respectively, infect rats and humans.
PCP can be a fatal condition if not treated early. Moderate to severe cases of PCP can benefit vastly from corticosteroids. This can significantly improve the prognosis and decrease the incidence of death.
Not indicated for children less than 13 years
For more than 13 years as prophylaxis, 1500 mg orally once daily with food
Mild-to-Moderate Pneumocystis jirovecii Pneumonia
Not indicated for children less than 13 years
For more than 13 years, 750mg/5ml twice daily taken with food for 21 days
Pneumocystis Jirovecii Pneumonia, previously known as Pneumocystis Carinii Pneumonia, is a fungal illness that most frequently affects immunocompromised individuals which can be fatal in extreme cases. Patients with underlying condition which significantly compromise immunity are at risk. Conditions such as AIDS, or cancer substantially add to the risk, and Patients with underlying condition which significantly compromise immunity are at risk.
Conditions such as AIDS, or cancer substantially add to the risk, and transplant patients also experience severe symptoms. Any other illnesses which are treated with immunosuppressive medication could also result in a fatal outcome when infected with Pneumocystis jirovecii pneumonia. Individuals affected with PCP may develop symptoms such cough, dyspnea, fever, and in extreme cases may experience respiratory failure. It is suspected that pneumocystis is transmitted from human to human through the air.
Asymptomatic lung colonization can occur in persons with healthy immune systems, and these individuals may unwittingly serve as reservoirs for the transmission of Pneumocystis to immunocompromised hosts. Although it is still the most prevalent and severe opportunistic respiratory infection in individuals with AIDS, the prevalence of infection in this population has decreased significantly due to the widespread use of antiretroviral and prophylaxis therapy.
Pneumocystis originally surfaced in Europe in malnourished newborns in institutions after World War II. Prior to the HIV epidemic in the 1980s, little was understood about the organism, and as a result, research into this illness experienced a sudden urge because of AIDS. Pneumocystis jirovecii Pneumonia is now a known illness around the world.
Although it is commonly observed in individuals with a compromised immunity, it has now been observed infrequently in those with fully functional and healthy immune systems. Patients in certain immunocompromised conditions are extremely susceptible to PCP.
These include:
Individuals with cancer (particularly hematologic cancers)
Patients being treated for certain rheumatologic or inflammatory conditions
Patients who have undergone solid organ or hematopoietic cell transplants
Patients with any condition which causes defects in cell-mediated immunity
The combination of immunosuppressive therapy with the intake of glucocorticoids is the greatest risk factor for PCP among patients who aren’t infected with HIV. During the beginning of the HIV epidemic, almost 20% of individuals whose CD4+ levels were below 200 cells/microL were observed with PCP.
But, since 1989, PCP rates began to fall at the rate of 3.4% each year between 1992 and 1995, because of the use of antiretroviral and primary prophylaxis therapy. Between 1996 and 1998, the infection rates fell by 21.5% per year. Despite the fall in infection rates in the US and other industrialized nations, this infection is still the major cause of severe illness in immunocompromised patients.
Pneumocystis jirovecii typically infects the lungs of immunocompromised individuals. Pneumocystis binds to Type I alveolar epithelium, allowing it to convert from its small trophic form to its bigger cystic form, as revealed by microscopic investigation.
Pneumocystis adhesion to alveoli is not the sole cause of diffuse alveolar damage; rather, the host’s inflammatory response leads to impaired exchange of gases and severe lung damage, which causes hypoxia and potentially respiratory failure.
This infection is primarily an infection of the alveoli, however the rare, disseminated form may be observed in immunocompromised individuals.
In 1988, Pneumocystis was recognized as an ascomycetous fungus. Previously, it was assumed that Pneumocystis belonged to the protozoan class. It was believed that its life cycle resembled the lifecycle of a fungus as well as a protozoan. Eventually, disagreement over its precise categorization prompted additional research.
Through meticulous phylogenetic analysis of small subunit ribosomal RNAs, scientists have been able to compare the lineages of plants, animals, fungi, and protozoa.
On the basis of the structure of important enzymes, gene sequencing, and cell wall composition, researchers have ascertained that Pneumocystis is a member of the fungus family. The Pneumocystis genus has numerous species, including P. jirovecii and P. carinii, which, respectively, infect rats and humans.
PCP can be a fatal condition if not treated early. Moderate to severe cases of PCP can benefit vastly from corticosteroids. This can significantly improve the prognosis and decrease the incidence of death.
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