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Med Mal Infect. 2014 May;44(5):185-98. doi: 10.1016/j.medmal.2014.01.007. Epub 2014 Mar 11.

Update on pulmonary Pneumocystis jirovecii infection in non-HIV patients.

Author information

1
Service de pneumologie, hôpital Foch, 92151 Suresnes, France.
2
Service de réanimation médico-chirurgicale, hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 93009 Bobigny, France.
3
Service de radiologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 93009 Bobigny, France.
4
Service des urgences, Gustave Roussy, Cancer Campus Grand Paris, 94805 Villejuif, France.
5
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.
6
UPLIN, CHU d'Angers, 49100 Angers, France; Université d'Angers, 49100 Angers, France.
7
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.
8
Service de radiologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris (AP-HP), 93009 Bobigny, France; Université Paris-13, 93009 Bobigny, France.
9
Service de réanimation polyvalente, CHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France. Electronic address: frncsvncnt@aol.com.

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.

KEYWORDS:

Immunodepression; Immunodépression; Pneumocystis jirovecii; Pneumonia; Pneumopathie

PMID:
24630595
DOI:
10.1016/j.medmal.2014.01.007
[Indexed for MEDLINE]

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