Pneumocystis infection in humans: diagnosis and treatment

Abstract

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.

Keywords::

• β-1,3-glucan
• diagnosis
• Pneumocystis jirovecii
• Pneumocystis PCR
• Pneumocystis pneumonia
• pneumocystosis
• prevention
• S-adenosylmethionine
• treatment

Financial & competing interests disclosure

This work was supported by the French Ministry of Research (EA3609 University Lille Nord-de-France and Institut Pasteur de Lille), by the National Agency of Research (ANR) in the framework of ‘Biodiversité’ Program (CERoPath network), by ANR-ERA-NET ‘Pneumocystis PathoGenoMics’ Program (ANR-06-PATHO-009-01) and by the Spanish Ministry of Science and Innovation (FIS-PI080983). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.