Pneumocystis infection in humans: diagnosis and treatment.
Pneumocystis jirovecii is an atypical fungus exhibiting pulmonary tropism and a highly defined host specificity. It is generally regarded as an opportunistic microorganism causing serious pneumonia in AIDS patients. However, with the currently rising number of patients receiving immunosuppressive therapies for malignancies, allogeneic organ transplantations and autoimmune diseases, Pneumocystis pneumonia is becoming more and more recognized in non-HIV immunosuppressed individuals. The clinical presentation in HIV-infected patients may differ from that in other immunocompromised patients and its diagnosis continues to be challenging as there are no specific symptoms or signs. Cotrimoxazole is the drug of choice for prophylaxis and therapy of any form or severity of Pneumocystis pneumonia, but there are only a few options for other alternative treatments. The management of this pneumonia remains a major challenge for all physicians caring for immunosuppressed patients.
Instituto de Biomedicina de Sevilla, and CIBER de Epidemiología y Salud Pública, Servicio de Medicina Interna, Virgen del Rocío University Hospital, Seville, Spain. ecalderon@ibis-sevilla.es
Enrique J
EJ
Calderón
Sonia
S
Gutiérrez-Rivero
Isabelle
I
Durand-Joly
Eduardo
E
Dei-Cas
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D000935:Antifungal Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D045363:Pneumocystis carinii / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control
D000935:Antifungal Agents