title: Update on pulmonary Pneumocystis jirovecii infection in non-HIV patients.
abstract: Pneumocystis jirovecii is the only fungus of its kind to be pathogenic in humans. It is primarily responsible for pneumonia (PJP). The key to understanding immune defences has focused on T-cells, mainly because of the HIV infection epidemic. Patients presenting with PJP all have a CD4 count below 200/mm(3). The introduction of systematic primary prophylaxis and the use of new anti-retroviral drugs have significantly reduced the incidence of this disease in the HIV-infected population, mainly in developed countries. The increasingly frequent use of corticosteroids, chemotherapy, and other immunosuppressive drugs has led to an outbreak of PJP in patients not infected by HIV. These patients presenting with PJP have more rapid and severe symptoms, sometimes atypical, leading to delay the initiation of a specific anti-infective therapy, sometimes a cause of death. However, the contribution of new diagnostic tools and a better understanding of patients at risk should improve their survival.
authors.affiliation: Service de pneumologie, hôpital Foch, 92151 Suresnes, France.
authors.forename: A
authors.initials: A
authors.lastname: Roux
authors.affiliation: Service de réanimation médico-chirurgicale, hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 93009 Bobigny, France.
authors.forename: F
authors.initials: F
authors.lastname: Gonzalez
authors.affiliation: Service de radiologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 93009 Bobigny, France.
authors.forename: M
authors.initials: M
authors.lastname: Roux
authors.affiliation: Service des urgences, Gustave Roussy, Cancer Campus Grand Paris, 94805 Villejuif, France.
authors.forename: M
authors.initials: M
authors.lastname: Mehrad
authors.affiliation: Service de parasitologie-mycologie, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France; Université Paris-Diderot, Sorbonne Paris-Cité, 75010 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Menotti
authors.affiliation: UPLIN, CHU d'Angers, 49100 Angers, France; Université d'Angers, 49100 Angers, France.
authors.forename: J-R
authors.initials: JR
authors.lastname: Zahar
authors.affiliation: Service de réanimation médico-chirurgicale, hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 93009 Bobigny, France.
authors.forename: V-X
authors.initials: VX
authors.lastname: Tadros
authors.affiliation: Service de réanimation médicale, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris (AP-HP), 75010 Paris, France; Université Paris-Diderot, Sorbonne Paris-Cité, 75010 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Azoulay
authors.affiliation: Service de radiologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 93009 Bobigny, France; Université Paris-13, 93009 Bobigny, France.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Brillet
authors.affiliation: Service de réanimation polyvalente, CHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France. Electronic address: frncsvncnt@aol.com.
authors.forename: F
authors.initials: F
authors.lastname: Vincent
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D003240:Connective Tissue Diseases / Q000150:complications / Q000188:drug therapy; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D018023:HIV Seronegativity; D006801:Humans; D016867:Immunocompromised Host; D007153:Immunologic Deficiency Syndromes / Q000150:complications; D007155:Immunologic Factors / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D016377:Organ Transplantation; D016720:Pneumocystis Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D045363:Pneumocystis carinii / Q000187:drug effects / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D016133:Polymerase Chain Reaction / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D011859:Radiography; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D047071:beta-Glucans / Q000097:blood
chemical_list: D000305:Adrenal Cortex Hormones; D000970:Antineoplastic Agents; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D047071:beta-Glucans; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
keywords: Immunodepression; Immunodépression; Pneumocystis jirovecii; Pneumonia; Pneumopathie