No abstract available.
Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis*

No abstract available.
Autopsy* ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia, Pneumocystis*

The cytological and ultrastructural findings of Pneumocystis carinii(PC) obtained from rats by bronchoalveolar lavage(BAL) are described. All developmental forms of the PC organisms were obtained in the lavage fluid. Ultrastructurally, the cysts were almost circular in shape, and were nearly devoid of surface tubular extensions. The wall of the cyst was composed of an unit membrane, and intermediate electron lucent layer and an external electron dense layer. The cysts frequently contained intracystic bodies, so called sporozoites. Occasionally empty or collapsed cysts with no intracystic bodies, and precysts were found. Trophozoites were variable in size and shape with abundant tubular extensions along the single electron dense pellicle. BAL is a useful method for concentrating the various morphologic forms of PC organisms, and is a rapid diagnostic method for PC pneumonia.
Animals ; Bronchoalveolar Lavage* ; Membranes ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia ; Pneumonia, Pneumocystis* ; Rats ; Sporozoites ; Therapeutic Irrigation ; Trophozoites

Pneumocystis, an important opportunistic fungal pathogen that parasitizes in multiple mammalian lungs, may cause life-threatening Pneumocystis pneumonia (PCP) and even death among immunocompromised individuals. With the rapid development of high-throughput sequencing and multi-omics technologies, systematic comparative analyses of genome, transcriptome, and whole-genome sequencing results demonstrate that Pneumocystis is a type of obligate biotrophic fungi, and requires obtaining nutrition from hosts. In addition, sexual reproduction is an essential process for Pneumocystis survival, production and transmission, and asexual reproduction facilitates Pneumocystis survival, which provides new insights into understanding of the whole developmental process of Pneumocystis in the host lung and inter-host transmission of Pneumocystis. This review summarizes the advances in the reproduction mode of Pneumocystis and underlying mechanisms, which provides insights into prevention and treatment of PCP, notably for the prophylaxis against nosocomial transmission of PCP.
Humans ; Lung/microbiology* ; Pneumocystis/genetics* ; Pneumonia, Pneumocystis/microbiology*

No abstract available.
Bronchoalveolar Lavage Fluid* ; Bronchoalveolar Lavage* ; Early Diagnosis* ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia, Pneumocystis*

Pneumocystis carinii pneumonia (PCP) is an infectious disease of immune-compromised host. Sometimes it is difficult to differentiate PCP with diffuse pulmonary hemorrhage. Association between PCP and diffuse pulmonary hemorrhage has been reported in 30% of PCP with HIV positive patients. But association between PCP and diffuse pulmonary hemorrhage has not been reported in non-HIV positive patients without any known underlying causes of diffuse pulmonary hemorrhage. We report a case of PCP with diffuse pulmonary hemorrhage in 66 years old male patient. We confirmed PCP and diffuse pulmonary hemorrhage with bronchoalveolar lavage. We can exclude the possible other causes of diffuse pulmonary hemorrhage except PCP. PCP may be one of possible cause of diffuse pulmonary hemorrhage in non-HIV immune compromised patient.
Aged ; Bronchoalveolar Lavage ; Communicable Diseases ; Hemorrhage* ; HIV ; Humans ; Male ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia, Pneumocystis*

Pneumocystis carinii pneumonia (PCP), now known as Pneumocystis jirovecii, is a fungal pathogen that causes opportunistic disease, especially pneumonia, in immunocompromised patients. The patients can have a spectrum of illnesses ranging from asymptomatic to fulminant respiratory failure. Here we report two cases with pneumocystis pneumonia after liver transplantation who presented with different clinical features. One patient developed acute respiratory failure requiring mechanical ventilation and expired due to PCP and a superimposed bacterial infection. The other patient was asymptomatic and discovered by regular X-ray check-up. He was successfully treated with trimethoprim/sulfamethoxazole. As shown by our cases, PCP presents with broad clinical manifestations and leads to various clinical courses in liver transplant recipients. Thus, Pneumocystis jirovecii has to be considered a potential pathogen of pneumonia in liver transplant recipients regardless of severity, especially one who is not on prophylactic medications. We consider prophylaxis of PCP in liver transplant recipients in our center.
Bacterial Infections ; Humans ; Immunocompromised Host ; Liver ; Liver Transplantation ; Pneumocystis ; Pneumocystis jirovecii ; Pneumonia ; Pneumonia, Pneumocystis ; Respiration, Artificial ; Respiratory Insufficiency

BACKGROUND: Pneumocystis jirovecii is a fungus that has become an important cause of opportunistic infections. We present a summary of the clinical status and findings from bronchoalveolar lavage (BAL) of patients with Pneumocystis jirovecii pneumonia (PJP). METHODS: We selected 30 cases of PJP that were proven through a surgical specimen evaluation. BAL fluid cytology was reviewed, and agreement with the initial diagnosis was evaluated. RESULTS: All 30 cases of PJP occurred in immunocompromised patients. Only 15 of the 30 cases were initially diagnosed as PJP. We found PJP in 13 of the 15 cases that were negative at the initial diagnosis. The most characteristic finding of PJP was frothy exudates, and BAL fluid tended to show rare neutrophils. Two of seven patients with PJP and diffuse alveolar damage (DAD) revealed no frothy exudates in BAL fluid. CONCLUSION: BAL fluid cytology was reconfirmed as a sensitive and rapid method to diagnose PJP. We must be aware of the possibility of PJP to maintain high diagnostic sensitivity. We cannot exclude PJP in cases of PJP with DAD, even if frothy exudates are not observed in the BAL fluid.
Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; Exudates and Transudates ; Fungi ; Humans ; Immunocompromised Host ; Neutrophils ; Opportunistic Infections ; Pneumocystis ; Pneumocystis carinii ; Pneumocystis jirovecii ; Pneumonia

Pneumocystis carinii pneumonia (PCP) has rarely been reported in solid tumor patients. It is a well-known complication in immunosuppressed states including acquired immune deficiency syndrome and hematologic malignancy. PCP has been reported in solid tumor patients who received long-term steroid treatment due to brain or spinal cord metastases. We found 3 gastric cancer patients with PCP, who received only dexamethasone as an antiemetic during chemotherapy. The duration and cumulative dose of dexamethasone used in each patient was 384 mg/48 days, 588 mg/69 days, and 360 mg/42 days, respectively. These cases highlight that the PCP in gastric cancer patients can successfully be managed through clinical suspicion and prompt treatment. The cumulative dose and duration of dexamethasone used in these cases can be basic data for risk of PCP development in gastric cancer patients during chemotherapy.
Acquired Immunodeficiency Syndrome ; Brain ; Dexamethasone ; Hematologic Neoplasms ; Humans ; Neoplasm Metastasis ; Pneumocystis ; Pneumocystis carinii ; Pneumonia, Pneumocystis ; Spinal Cord ; Stomach Neoplasms

Pneumocystis pneumonia (PCP) is caused by the yeast-like fungus Pneumocystis jirovecii, which is specific to humans. PCP could be a source of opportunistic infection in adults that are immunosuppressed and children with prematurity or malnutrition. The diagnosis should be confirmed by identification of the causative organism, by analysis of the sputum, a bronchoalveolar lavage or a tissue biopsy. In both histologic and cytologic specimens, the cysts are contained within frothy exudates, which form aggregated clumps. The cysts often collapse forming crescent-shaped bodies that resemble ping-pong balls. We recently diagnosed nine cases of PCP using an immunohistochemical stain for Pneumocystis. The patients consisted of five human immunodeficiency virus positive individuals, two renal transplant recipients, and two patients with a malignant disease. All nine patients were infected with P. jirovecii, which was positive for monoclonal antibody 3F6. In conclusion, the immunohistochemical stain used in this report is a new technique for the detection of P. jirovecii infection.
Adult ; Biopsy ; Bronchoalveolar Lavage ; Child ; Exudates and Transudates ; Fungi ; HIV ; Humans ; Immunohistochemistry ; Malnutrition ; Opportunistic Infections ; Pneumocystis ; Pneumocystis jirovecii ; Pneumonia, Pneumocystis ; Sputum