Non-pneumonia Pneumocystis jirovecii colonization is thought to occur frequently in immunocompetent individuals. The aim was to analyze if P. jirovecii low-titer detections have more impact than just colonization. From our total cohort of patients for which P. jirovecii testing by qPCR was requested, we selected exclusively those that were fully immunocompetent. Patients were defined as fully i...

Introduction The majority of deaths from fungal infections occur in Africa. Pneumocystis is an unusual host-specific fungus that takes advantage of a weakened immune system and causes pneumonia in AIDS patients [1]. While Pneumocystis is thought to cause more than 200,000 AIDSrelated deaths annually, it also contributes to more than 50,000 non–AIDS-related deaths [2]. Recent epidemiological dat...

The appearance of primary HIV infection ranges from an asymptomatic presentation to a symptomatic illness resembling infectious mononucleosis. Severe unusual presentations include acute myopericarditis, renal failure, and opportunistic infections such as esophageal candidiasis, cytomegalovirus infection, and Pneumocystis jirovecii pneumonia. We report a case of multiple organ failure during pri...

A 39-year-old male with newly diagnosed HIV had cavitary pneumonia initially attributed to Pneumocystis jirovecii but actually caused by Rhodococcus equi. After neurological deterioration, he was found to have intracerebral lesions caused by Toxoplasma gondii. This case underscores the inability to rely on the search for a unifying diagnosis (Ockham's Razor) in HIV-infected patients.

We conducted a prospective pilot study of the serologic responses to overlapping recombinant fragments of the Pneumocystis jirovecii major surface glycoprotein (Msg) in HIV-infected patients with pneumonia due to P. jirovecii and other causes. Similar baseline geometric mean antibody levels to the fragments measured by an ELISA were found in both groups. Serum antibodies to MsgC in P. jirovecii...

INTRODUCTION The opportunistic fungus Pneumocystis jirovecii causes Pneumocystis pneumonia (PcP), which is a life-threatening infection in HIV/AIDS patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate because many HIV/AIDS patients reside in this region. The lack of suitable diagnostic practices in this resource limited-region ...

The utility of quantitative Pneumocystis jirovecii PCR in clinical routine for diagnosing Pneumocystis pneumonia (PCP) in immunocompromised non-HIV patients is unknown. We analysed bronchoalveolar lavage fluid with real-time quantitative P. jirovecii PCR in 71 cases with definitive PCP defined by positive immunofluorescence (IF) tests and in 171 randomly selected patients with acute lung diseas...

A 66-year-old male treated with everolimus for renal cell carcinoma developed exertional dyspnea. Chest computed tomography revealed diffuse interstitial shadows on both lungs. Bronchoalveolar lavage and the drug-induced lymphocyte stimulation test confirmed the diagnosis of drug-induced interstitial lung disease due to everolimus therapy. However, discontinuation of everolimus in combination w...

Pneumocystis jirovecii is an unculturable fungus and the causative agent of Pneumocystis pneumonia, a life-threatening opportunistic infection. Although molecular diagnosis is often based on the detection of mtLSU rRNA mitochondrial gene, the number of copies of mitochondrial genes had not been investigated. We developed and optimized six real-time PCR assays in order to determine the copy numb...

Systemic antifungal agents and their use for the therapy of invasive mycoses are discussed in this chapter. Many of these agents can also be used to treat the mucocutaneous forms of candidiasis, but those uses are discussed in detail in Chapter 257 and thus are mentioned only in passing here. Similarly, the therapy of the various forms of tinea and onychomycosis with topical agents or systemic ...