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Review

Pneumocystis infection in humans: diagnosis and treatment

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Pages 683-701 | Published online: 10 Jan 2014

References

  • No authors listed. Revised nomenclature for Pneumocystis carinii. The Pneumocystis Workshop. J. Eukaryot. Microbiol.41, S121–S122 (1994).
  • Van der Meer G, Brug SL. Infection a Pneumocystis chez l`homme et chez les animaux. Ann. Soc. Belg. Med. Trop.22, 301–307 (1942).
  • Calderon-Sandubete EJ, Varela-Aguilar JM, Medrano-Ortega FJ et al. Historical perspective on Pneumocystis carinii infection. Protist153, 303–310 (2002).
  • Morris A, Lundgren JD, Masur H et al. Current epidemiology of Pneumocystis pneumonia. Emerg. Infect. Dis.10, 1713–1720 (2004).
  • Hughes WT. Pneumocystis pneumonitis in non-HIV-infected patients: update. In: Pneumocystis carinii Pneumonia (3rd Edition). Walzer PD, Cushion MT (Eds). Marcel Dekker, Inc., NY, USA, 407–434 (2004).
  • Peterson JC, Cushion MT. Pneumocystis : not just pneumonia. Curr. Opin. Microbiol.8, 393–398 (2005).
  • Magne D, Angoulvant A, Botterel F et al. Réseau pneumocystose francilien: bilan de cinq années de surveillance (2003–2007). J. Mycol. Med.19, 290–293 (2009).
  • Calderón EJ, Varela JM, Medrano FJ et al. Epidemiology of Pneumocystis carinii pneumonia in southern Spain. Clin. Microbiol. Infect.10, 673–676 (2004).
  • Roblot F. Management of Pneumocystis pneumonia in patients with inflammatory disorders. Expert. Rev. Anti Infect. Ther.3, 435–444 (2005).
  • Rodriguez M, Fishman JA. Prevention of infection due to Pneumocystis spp. in human immunodeficiency virus-negative immunocompromised patients. Clin. Microbiol. Rev.17, 770–782 (2004).
  • Cardenal R, Medrano FJ, Varela JM et al.Pneumocystis carinii pneumonia in heart transplant recipients. Eur. J. Cardiothorac. Surg.20, 799–802 (2001).
  • Takeuchi T, Tatsuki Y, Nogami Y et al. Postmarketing surveillance of the safety profile of infliximab in 5000 Japanese patients with rheumatoid arthritis. Ann. Rheum. Dis.67, 189–194 (2008).
  • Kalyoncu U, Karadag O, Akdogan A et al.Pneumocystis carinii pneumonia in a rheumatoid arthritis patient treated with adalimumab. Scand. J. Infect Dis.39, 475–478 (2007).
  • Lahiff C, Khiaron OB, Nolan N, Chadwick GA. Pneumocystis carinii pneumonia in a patient on etanercept for psoriatic arthritis. Ir. J. Med. Sci.176, 309–311 (2007).
  • Shelton E, Yong M, Cohney S. Late onset Pneumocystis pneumonia in patients receiving rituximab for humoral renal transplant rejection. Nephrology (Carlton)14, 696–699 (2009).
  • Cruciani M, Marcati P, Malena M, Bosco O, Serpelloni G, Mengoli C. Meta-analysis of diagnostic procedures for Pneumocystis carinii pneumonia in HIV-1-infected patients. Eur. Respir. J.20, 982–989 (2002).
  • Thomas CF, Limper AH. Pneumocystis pneumonia. N. Engl. J. Med.350, 2487–2498 (2004).
  • Wazir JF, Ansari NA. Pneumocystis carinii infection. Update and review. Arch. Pathol. Lab. Med.128, 1023–1027 (2004).
  • Krajicek BJ, Limper AH, Thomas CF. Advances in the biology, pathogenesis and identification of Pneumocystis pneumonia. Curr. Opin. Pulm. Med.14, 228–234 (2008).
  • Krajicek BJ, Thomas CF, Limper AH. Pneumocystis pneumonia: current concepts in pathogenesis, diagnosis, and treatment. Clin. Chest Med.30, 265–278 (2009).
  • Kovacs JA, Masur H. Evolving health effects of Pneumocystis. JAMA301, 2578–2585 (2009).
  • Pyrgos V, Shoham S, Roilides E, Walsh TJ. Pneumocystis pneumonia in children. Paediatr. Respir. Rev.10, 192–198 (2009).
  • Schliep TC, Yarrish RL. Pneumocystis carinii pneumonia. Semin. Respir. Infect.14, 333–343 (1999).
  • Nyamande K, Lalloo UG, Vawda F. Comparison of plain chest radiography and high-resolution CT in human immunodeficiency virus infected patients with community-acquired pneumonia: a sub-Saharan Africa study. Br. J. Radiol.80, 302–306 (2007).
  • Mori S, Polatino S, Estrada-Y-Martin RM. Pneumocystis -associated organizing pneumonia as a manifestation of immune reconstitution inflammatory syndrome in an HIV-infected individual with a normal CD4+ T-cell count following antiretroviral therapy. Int. J. STD AIDS20, 662–665 (2009).
  • Jagannathan P, Davis E, Jacobson M, Huang L. Life-threatening immune reconstitution inflammatory syndrome after Pneumocystis pneumonia: a cautionary case series. AIDS23, 1794–1796 (2009).
  • Cheng VC, Hung IF, Wu AK, Tang BS, Chu CM, Yuen KY. Lymphocyte surge as a marker for immunorestitution disease due to Pneumocystis jiroveci pneumonia in HIV-negative immunosuppressed hosts. Eur. J. Clin. Microbiol. Infect. Dis.23, 512–514 (2004).
  • Wislez M, Bergot E, Antoine M et al. Acute respiratory failure following HAART introduction in patients treated for Pneumocystis carinii pneumonia. Am. J. Respir. Crit. Care Med.164, 847–851 (2001).
  • Wu AK, Cheng VC, Tang BS et al. The unmasking of Pneumocystis jiroveci pneumonia during reversal of immunosuppression: case reports and literature review. BMC Infect. Dis.4, 57 (2004).
  • Slivka A, Wen PY, Shea WM, Loeffler JS. Pneumocystis carinii pneumonia during steroid taper in patients with primary brain tumors. Am. J. Med.94, 216–219 (1993).
  • Fulkerson WJ, Newman JH. Endogenous Cushing’s syndrome complicated by Pneumocystis carinii pneumonia. Am. Rev. Respir. Dis.129, 188–189 (1984).
  • Ng VL, Yajko DM, Hadley WK. Extrapulmonary pneumocystosis. Clin. Microbiol. Rev.10, 401–418 (1997).
  • Chalvardjian AM, Grawe LA. A new procedure for the identification of Pneumocystis carinii cysts in tissue sections and smears. J. Clin. Pathol.16, 383–384 (1963).
  • Grocott RG. A stain for fungi in tissue sections and smears using Gomori’s methenamine-silver nitrate technic. Am. J. Clin. Pathol.25, 975–979 (1955).
  • Walzer PD, Kim CK, Cushion MT. Pneumocystis carinii. In: Parasitic Infections in the Compromised Host. Walzer PD, Genta RM (Eds). Marcel Dekker, NY, USA, 83–78 (1989).
  • Yoshikawa H, Yoshida Y. Localization of silver deposits on Pneumocystis carinii treated with Gomori’s methenamine silver nitrate stain. Zentralbl. Bakteriol. Mikrobiol. Hyg. A.264, 363–372 (1987).
  • Cushion MT, Ruffolo JJ, Linke MJ, Walzer PD. Pneumocystis carinii: growth variables and estimates in the A549 and WI-38 VA13 human cell lines. Exp. Parasitol.60, 43–54 (1985).
  • Dei-Cas E, Fleurisse L, Aliouat EM et al. Morphological and ultrastructural methods for Pneumocystis. FEMS Immunol. Med. Microbiol.22, 185–189 (1998).
  • Durand-Joly I, Wakefield AE, Palmer RJ et al. Ultrastructural and molecular characterization of Pneumocystis carinii isolated from a rhesus monkey (Macaca mulatta). Med. Mycol.38, 61–72 (2000).
  • Chouaid C, Housset B, Lebeau B. Cost-analysis of four diagnostic strategies for Pneumocystis carinii pneumonia in HIV-infected subjects. Eur. Respir. J.8, 1554–1558 (1995).
  • Dei-Cas E, Aliouat EM, Cailliez JC. Pneumocystis cellular structure. In: Pneumocystis carinii Pneumonia (3rd Edition). Walzer PD, Cushion MT (Eds). Marcel Dekker, Inc., NY, USA, 61–94 (2004).
  • Dei-Cas E, Chabé M, Moukhlis R et al.Pneumocystis oryctolagi sp. nov., an uncultured fungus causing pneumonia in rabbits at weaning: review of current knowledge, and description of a new taxon on genotypic, phylogenetic and phenotypic bases. FEMS Microbiol. Rev.30, 853–871 (2006).
  • Kovacs JA, Ng VL, Masur H et al. Diagnosis of Pneumocystis carinii pneumonia: improved detection in sputum with use of monoclonal antibodies. N. Engl. J. Med.318, 589–593 (1988).
  • Limawongpranee S, Wanachiwanawin D, Chokephaibulkit K, Onchrotchanakun J, Lertlaituan P, Wankhom S. Sensitive detection of Pneumocystis jirovecii DNA in gastric wash using nested polymerase chain reaction. Southeast Asian J. Trop. Med. Public Health38, 892–896 (2007).
  • Aderaye G, Woldeamanuel Y, Asrat D et al. Evaluation of Toluidine Blue O staining for the diagnosis of Pneumocystis jiroveci in expectorated sputum sample and bronchoalveolar lavage from HIV-infected patients in a tertiary care referral center in Ethiopia. Infection36, 237–243 (2008).
  • Broaddus C, Dake MD, Stulbarg MS et al. Bronchoalveolar lavage and transbronchial biopsy for the diagnosis of pulmonary infections in the acquired immunodeficiency syndrome. Ann. Intern. Med.102, 747–752 (1985).
  • Huang L, Hecht FM, Stansell JD, Montanti R, Hadley WK, Hopewell PC. Suspected Pneumocystis carinii pneumonia with a negative induced sputum examination: is early bronchoscopy useful? Am. J. Respir. Crit. Care Med.151, 1866–1871 (1995).
  • Wakefield AE, Pixley FJ, Banerji S et al. Detection of Pneumocystis carinii with DNA amplification. Lancet336, 451–453 (1990).
  • Olsson M, Elvin K, Löfdahl S, Linder E. Detection of Pneumocystis carinii DNA in sputum and bronchoalveolar lavage samples by polymerase chain reaction. J. Clin. Microbiol.31, 221–226 (1993).
  • De la Horra C, Varela JM, Friaza V et al. Comparison of single and touchdown PCR protocols for detecting Pneumocystis jirovecii DNA in paraffin-embedded lung tissue samples. J. Eukaryot. Microbiol.53(Suppl. 1), 98–99 (2006).
  • Durand-Joly I, Chabé M, Soula F, Delhaes L, Camus D, Dei-Cas E. Molecular diagnosis of Pneumocystis pneumonia (PcP). FEMS Immunol. Med. Microbiol.45, 405–410 (2005).
  • Durand-Joly I, Soula F, Chabe M et al. Longterm colonization with Pneumocystis jirovecii in hospital staffs: a challenge to prevent nosocomial pneumocystosis. J. Eukaryot. Microbiol.50(Suppl.), 614–615 (2003).
  • Azoulay E, Bergeron A, Chevret S, Bele N, Schlemmer B, Menotti J. Polymerase chain reaction for diagnosing Pneumocystis pneumonia in non-HIV immunocompromised patients with pulmonary infiltrates. Chest135, 655–661 (2009).
  • Peters SE, English K, Laakkonen J, Gurnell J. DNA analysis of Pneumocystis carinii infecting Finnish and English shrews. J. Eukaryot. Microbiol.41(Suppl.), 108 (1994).
  • Mazars E, Guyot K, Fourmaintraux S et al. detection of Pneumocystis in European wild animals. J. Eukaryot. Microbiol.44(Suppl.), 39 (1994).
  • Wakefield AE. DNA sequences identical to Pneumocystis carinii f.sp. carinii and Pneumocystis carinii f.sp. hominis in samples of air spora. J. Clin. Microbiol.34, 1754–1759 (1996).
  • Bartlett MS, Vermund SH, Jacobs R et al. Detection of Pneumocystis carinii DNA in air samples: likely environmental risk to susceptible persons. J. Clin. Microbiol.35, 2511–2513 (1997).
  • Casanova-Cardiel L, Leibowitz MJ. Presence of Pneumocystis carinii DNA in pond water. J. Eukaryot. Microbiol.44(Suppl.), 28 (1997).
  • Aliouat-Denis CM, Chabé M, Demanche C et al.Pneumocystis species, coevolution and pathogenic power. Infect. Genet. Evol.8, 708–726 (2008).
  • Esteves F, Montes-Cano MA, de la Horra C et al.Pneumocystis jirovecii multilocus genotyping profiles in patients from Portugal and Spain. Clin. Microbiol. Infect.14, 356–362 (2008).
  • Chabé M, Herbreteau V, Hugot JP et al.Pneumocystis carinii and Pneumocystis wakefieldiae in wild Rattus norvegicus trapped in Thailand. J. Eukaryot Microbiol.57, 213–217 (2010).
  • Nevez G, Totet A, Jounieaux V, Schmit JL, Dei-Cas E, Raccurt C. Pneumocystis jirovecii internal transcribed spacer types in patients colonized by the fungus and in patients with pneumocystosis from the same French geographic region. J. Clin. Microbiol.41, 181–186 (2003).
  • Wissmann G, Morilla R, Friaza V, Calderón E, Varela JM. El ser humano como reservorio de Pneumocystis. Enferm. Infecc. Microbiol. Clin.28, 38–43 (2010).
  • Respaldiza N, Montes-Cano MA, Friaza V et al. Usefulness of oropharyngeal washings for identifying Pneumocystis jirovecii carriers. J. Eukaryot. Microbiol.53(Suppl. 1), 100–101 (2006).
  • Medrano FJ, Montes-Cano M, Conde M et al.Pneumocystis jirovecii in general population. Emerg. Infect. Dis.11, 245–250 (2005).
  • Nevez G, Chabé M, Rabodonirina M et al. Nosocomial Pneumocystis jirovecii infections. Parasite15, 359–365 (2008).
  • Tsolaki AG, Miller RF, Wakefield AE. Oropharyngeal samples for genotyping and monitoring response to treatment in AIDS patients with Pneumocystis carinii pneumonia. J. Med. Microbiol.48, 897–905 (1999).
  • Tamburrini E, Mencarini P, Visconti E et al. Potential impact of Pneumocystis genetic diversity on the molecular detection of the parasite in human host. FEMS Immunol. Med. Microbiol.22, 37–49 (1998).
  • Huggett JF, Taylor MS, Kocjan G et al. Development and evaluation of a real-time PCR assay for detection of Pneumocystis jirovecii DNA in bronchoalveolar lavage fluid of HIV-infected patients. Thorax63, 154–159 (2008).
  • Huang L. Clinical presentation and diagnosis of Pneumocystis pneumonia in HIV-infected patients. In: Pneumocystis carinii Pneumonia (3rd Edition). Walzer PD, Cushion MT (Eds). Marcel Dekker, Inc., NY, USA, 349–406 (2004).
  • Durand-Joly I. Épidémiologie moléculaire de la pneumocystose humaine. Caractérisation génétique et phénotypique de Pneumocystis jirovecii et espèces proches. Thesis, Lille 2 University, Lille, France (2002).
  • Wakefield AE, Miller RF, Guiver LA, Hopkin JM. Oropharyngeal samples for detection of Pneumocystis carinii by DNA amplification. Q. J. Med.86, 401–406 (1993).
  • Helweg-Larsen J, Jensen JS, Lundgren B. Noninvasive diagnosis of Pneumocystis carinii pneumonia in haematological patients using PCR on oral washes. J. Eukaryot. Microbiol.44(Suppl.), 59 (1997).
  • Khan MA, Farrag N, Butcher P. Diagnosis of Pneumocystis carinii pneumonia: immunofluorescence staining, simple PCR or nPCR. J. Infect.39, 77–80 (1999).
  • Richards CG, Wakefield AE, Mitchell CD. Detection of Pneumocystis DNA in nasopharyngeal aspirates of leukaemic infants with pneumonia. Arch. Dis. Child.71, 254–255 (1994).
  • Larsen HH, Huang L, Kovacs JA et al. A prospective, blinded study of quantitative touch-down polymerase chain reaction using oral-wash samples for diagnosis of Pneumocystis pneumonia in HIV-infected patients. J. Infect. Dis.189, 1679–1683 (2004).
  • Calderon EJ. Epidemiology of Pneumocystis infection in human. J. Mycol. Med.19, 270–275 (2009).
  • Larsen HH, Masur H, Kovacs JA et al. Development and evaluation of a quantitative, touchdown, real-time PCR assay for diagnosing Pneumocystis carinii pneumonia. J. Clin. Microbiol.40, 490–494 (2002).
  • Morris A, Wei K, Afshar K, Huang L. Epidemiology and clinical significance of Pneumocystis colonization. J. Infect. Dis.197, 10–17 (2008).
  • Vidal S, de la Horra C, Martín J et al.Pneumocystis jirovecii colonisation in patients with interstitial lung disease. Clin. Microbiol. Infect.12, 231–235 (2006).
  • Chabé M, Dei-Cas E, Creusy C et al. Immunocompetent hosts as a reservoir of Pneumocystis organisms: histological and RT-PCR data demonstrate active replication. Eur. J. Clin. Microbiol. Infect. Dis.23, 89–97 (2004).
  • Calderón EJ, Rivero L, Respaldiza N et al. Systemic inflammation in patients with chronic obstructive pulmonary disease who are colonized with Pneumocystis jirovecii. Clin. Infect. Dis.45, 17–19 (2007).
  • Tan WC, Ng TP. COPD in Asia: where east meets west. Chest133, 517–527 (2008).
  • Miller RF, Wakefield AE. Pneumocystis carinii genotypes and severity of pneumonia. Lancet353, 2039–2040 (1999).
  • Totet A, Pautard JC, Raccurt C, Roux P, Nevez G. Genotypes at the internal transcribed spacers of the nuclear rRNA operon of Pneumocystis jirovecii in nonimmunosuppressed infants without severe pneumonia. J. Clin. Microbiol.41, 1173–1180 (2003).
  • Beard CB. Molecular typing and epidemiological insights. In: Pneumocystis carinii Pneumonia (3rd edition). Walzer PD, Cushion MT (Eds). Marcel Dekker, Inc., NY, USA, 479–504 (2004).
  • Beser J, Hagblom P, Fernandez V. Frequent in vitro recombination in internal transcribed spacers 1 and 2 during genotyping of Pneumocystis jirovecii. J. Clin. Microbiol.45, 881–886 (2007).
  • Friaza V, Montes-Cano MA, Respaldiza N, Morilla R, Calderón EJ, de la Horra C. Prevalence of dihydropteroate synthase mutations in Spanish patients with HIV-associated Pneumocystis pneumonia. Diagn. Microbiol. Infect. Dis.64, 104–105 (2009).
  • Iliades P, Meshnick SR, Macreadie IG. Dihydropteroate synthase mutations in Pneumocystis jiroveci can affect sulfamethoxazole resistance in a Saccharomyces cerevisiae model. Antimicrob. Agents Chemother.48, 2617–2623 (2004).
  • Nahimana A, Rabodonirina M, Bille J, Francioli P, Hauser PM. Mutations of Pneumocystis jirovecii dihydrofolate reductase associated with failure of prophylaxis. Antimicrob. Agents Chemother.48, 4301–4305 (2004).
  • Huang L, Crothers K, Atzori C et al. Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance. Emerg. Infect. Dis.10, 1721–1728 (2004).
  • Kazanjian P, Armstrong W, Hossler PA et al. Pneumocystis carinii mutations are associated with duration of sulfa or sulfone prophylaxis exposure in AIDS patients. J. Infect. Dis.182, 551–557 (2000).
  • Huang L, Beard CB, Creasman J et al. Sulfa or sulfone prophylaxis and geographic region predict mutations in the Pneumocystis carinii dihydropteroate synthase gene. J. Infect. Dis.182, 1192–1198 (2000).
  • Helwe J, Benfield TL, Eugen-Olsen J, Lundgren JD, Lundgren B. Effects of mutations in Pneumocystis carinii dihydropteroate synthase gene on outcome of AIDS-associated P. carinii pneumonia. Lancet354, 1347–1351 (1999).
  • Valerio A, Tronconi E, Mazza F et al. Genotyping of Pneumocystis jirovecii pneumonia in Italian AIDS patients. Clinical outcome is influenced by dihydropteroate synthase and not by internal transcribed spacer genotype. J. Acquir. Immune Defic. Syndr.45, 521–528 (2007).
  • Alvarez-Martínez MJ, Moreno A, Miró JM et al. Pneumocystis jirovecii pneumonia in Spanish HIV-infected patients in the combined antiretroviral therapy era: prevalence of dihydropteroate synthase mutations and prognostic factors of mortality. Diagn. Microbiol. Infect. Dis.62, 34–43 (2008).
  • van Hal SJ, Gilgado F, Doyle T et al. Clinical significance and phylogenetic relationship of novel Australian Pneumocystis jirovecii genotypes. J. Clin. Microbiol.47, 1818–1823 (2009).
  • Stein CR, Poole C, Kazanjian P, Meshnick SR. Sulfa use, dihydropteroate sythase mutations, and Pneumocystis jirovecii pneumonia. Emerg. Infect. Dis.10, 1760–1765 (2004).
  • Navin TR, Beard CB, Huang L et al. Effect of mutations in Pneumocystis carinii dihydropteroate synthase gene on outcome of P. carinii pneumonia in patients with HIV-1: a prospective study. Lancet358, 545–549 (2001).
  • Calderon E, de la Horra C, Montes-Cano MA, Respaldiza N, Martín-Juan J, Varela JM. Resistencia genotípica a sulfamidas en pacientes con neumonía por Pneumocystis jiroveci. Med. Clin. (Barc.)122, 617–619 (2004).
  • Desmet S, Van Wijngaerden E, Maertens J et al. Serum (1–3)-β-D-glucan as a tool for diagnosis of Pneumocystis jirovecii pneumonia in patients with human immunodeficiency virus infection or hematological malignancy. J. Clin. Microbiol.47, 3871–3874 (2009).
  • Thomas CF Jr, Limper AH. Current insights into the biology and pathogenesis of Pneumocystis pneumonia. Nat. Rev. Microbiol.5, 298–308 (2007).
  • Teramoto S, Sawaki D, Okada S, Ouchi Y. Markedly increased plasma (1→3)-β-D-glucan is a diagnostic and therapeutic indicator of Pneumocystis carinii pneumonia in a non-AIDS patient. J. Med. Microbiol.49, 393–394 (2000).
  • Nakamura H, Tateyama M, Tasato D et al. Clinical utility of serum β-D-glucan and KL-6 levels in Pneumocystis jirovecii pneumonia. Intern. Med.48, 195–202 (2009).
  • Pontón J. Utilidad de los marcadores biológicos en el diagnóstico de la candidiasis invasora. Rev. Iberoam. Micol.26, 8–14 (2009).
  • Clarkson AB, Merali S. Polyamines, iron, and Pneumocystis carinii. In: Pneumocystis carinii Pneumonia (3rd Edition). Walzer PD, Cushion MT (Eds). Marcel Dekker, Inc., NY, USA, 577–605 (2004).
  • Skelly M, Hoffman J, Fabbri M, Holzman RS, Clarkson AB Jr, Merali S. S-adenosylmethionine concentrations in diagnosis of Pneumocystis carinii pneumonia. Lancet361, 1267–1268 (2003).
  • Skelly MJ, Holzman RS, Merali S. S-adenosylmethionine levels in the diagnosis of Pneumocystis carinii pneumonia in patients with HIV infection. Clin. Infect. Dis.46, 467–471 (2008).
  • Wang P, Huang L, Davis JL et al. A hydrophilic-interaction chromatography tandem mass spectrometry method for quantitation of serum S-adenosylmethionine in patients infected with human immunodeficiency virus. Clin. Chim. Acta396, 86–88 (2008).
  • Kutty G, Hernandez-Novoa B, Czapiga M, Kovacs JA. Pneumocystis encodes a functional S-adenosylmethionine synthetase gene. Eukaryot. Cell7, 258–267 (2008).
  • Walzer PD. Immunological features of Pneumocystis infection in humans. In: Pneumocystis carinii Pneumonia (3rd Edition). Walzer PD, Cushion MT (Eds). Marcel Dekker, Inc., NY, USA, 451–477 (2004).
  • Daly K, Koch J, Respaldiza N et al. Geographical variation in serological responses to recombinant Pneumocystis jirovecii major surface glycoprotein antigens. Clin. Microbiol. Infect.15, 937–942 (2009).
  • Centers for Disease Control and Prevention. Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. MMWR58, 1–216 (2009).
  • Zolopa A, Andersen J, Powderly W et al. Early antiretroviral therapy reduces AIDS progression/death in individuals with acute opportunistic infections: a multicenter randomized strategy trial. PLoS One4, e5575 (2009).
  • Helweg-Larsen J, Benfield T, Atzori C, Miller RF. Clinical efficacy of first- and second-line treatments for HIV-associated Pneumocystis jirovecii pneumonia: a tri-centre cohort study. J. Antimicrob. Chemother.64, 1282–1290 (2009).
  • Mofenson LM, Brady MT, Danner SP et al. Guidelines for the prevention and treatment of opportunistic infections among HIV-exposed and HIV-infected children: recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics. MMWR Recomm. Rep.58(RR-11), 1–166 (2009).
  • Crothers K, Beard CB, Turner J et al. Severity and outcome of HIV-associated Pneumocystis pneumonia containing Pneumocystis jirovecii dihydropteroate synthase gene mutations. AIDS19, 801–805 (2005).
  • Eeftinck Schattenkerk JK, Lange JM, van Steenwijk RP, Danner SA. Can the course of high dose cotrimoxazole for Pneumocystis carinii pneumonia in AIDS be shorter? A possible solution to the problem of cotrimoxazole toxicity. J. Intern. Med.227, 359–362 (1990).
  • Gordin FM, Simon GL, Wofsy CB, Mills J. Adverse reactions to trimethoprim–sulfamethoxazole in patients with the acquired immunodeficiency syndrome. Ann. Intern. Med.100, 495–499 (1984).
  • Hughes WT, LaFon SW, Scott JD, Masur H. Adverse events associated with trimethoprim–sulfamethoxazole and atovaquone during the treatment of AIDS-related Pneumocystis carinii pneumonia. J. Infect. Dis.171, 1295–1301 (1995).
  • Larsen HH, Masur H, Kovacs JA. Current regimens for treatment and prophylaxis of Pneumocystis jiroveci pneumonia. In: Pneumocystis carinii Pneumonia (3rd Edition). Walzer PD, Cushion MT (Eds). Marcel Dekker, Inc., NY, USA, 505–538 (2004).
  • Conte JE Jr, Chernoff D, Feigal DW Jr. et al. Intravenous or inhaled pentamidine for treating Pneumocystis carinii pneumonia in AIDS: a randomized trial. Ann. Intern. Med.113, 203–209 (1990).
  • O’Brien JG, Dong BJ, Coleman RL, Gee L, Balano KB. A 5-year retrospective review of adverse drug reactions and their risk factors in HIV-infected patients who were receiving intravenous therapy for Pneumocystis carinii pneumonia. Clin. Infect. Dis.24, 854–859 (1997).
  • Black JR, Feinberg J, Murphy RL, Fass RJ, Finkelstein D, Akil B. Clindamycin and primaquine therapy for mild-to-moderate episodes of Pneumocystis carinii pneumonia in patients with AIDS (ACTG 044). Clin. Infect. Dis.18, 905–913 (1994).
  • Toma E, Thorne A, Singer J et al. Clindamycin with primaquine vs. Trimethoprim–sulfamethoxazole therapy for mild and moderately severe Pneumocystis carinii pneumonia in patients with AIDS: a multicenter, double-blind, randomized trial. Clin. Infect. Dis.27, 524–530 (1998).
  • Medina I, Mills J, Leoung G et al. Oral therapy for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome: a controlled trial of trimethoprim–sulfamethoxazole versus trimethoprim-dapsone. N. Engl. J. Med.323, 776–782 (1990).
  • Baggish AL, Hill DR. Antiparasitic agent atovaquone. Antimicrob. Agents Chemother.46, 1163–1173 (2002).
  • Kazanjian P, Armstrong W, Hossler PA et al.Pneumocystis carinii cytochrome b mutations are associated with atovaquone exposure in patients with AIDS. J. Infect. Dis.183, 819–822 (2001).
  • Kovacs JA, Allegra CJ, Kennedy S et al. Efficacy of trimetrexate, a potent lipid-soluble antifolate, in the treatment of rodent Pneumocystis carinii pneumonia. Am. J. Trop. Med. Hyg.39, 491–496 (1988).
  • Allegra CJ, Kovacs JA, Drake JC, Swan JC, Chabner BA, Masur H. Activity of antifolates against Pneumocystis carinii dihydrofolate reductase and identification of a potent new agent. J. Exp. Med.165, 926–931 (1987).
  • Sattler FR, Frame P, Davis R et al. Trimetrexate with leucovorin versus trimethoprim–sulfamethoxazole for moderate to severe episodes of Pneumocystis carinii pneumonia in patients with AIDS: a prospective, controlled multicenter investigation of the AIDS Clinical Trials Group Protocol 029/031. J. Infect. Dis.170, 165–172 (1994).
  • Short CE, Gilleece YC, Fisher MJ, Churchill DR. Trimetrexate and folinic acid: a valuable salvage option for Pneumocystis jirovecii pneumonia. AIDS23, 1287–1290 (2009).
  • Briel M, Boscacci R, Furrer H, Bucher HC. Adjunctive corticosteroids for Pneumocystis jiroveci pneumonia in patients with HIV infection: a meta-analysis of randomised controlled trials. BMC Infect. Dis.5, 101 (2005).
  • Pareja JG, Garland R, Koziel H. Use of adjunctive corticosteroids in severe adult non-HIV Pneumocystis carinii pneumonia. Chest113, 1215–1224 (1998).
  • Miller RF, Le Noury J, Corbett EL, Felton JM, De Cock KM. Pneumocystis carinii infection: current treatment and prevention. J. Antimicrob. Chemother.37(Suppl. B), 33–53 (1996).
  • Smego RA Jr, Nagar S, Maloba B, Popara M. A meta-analysis of salvage therapy for Pneumocystis carinii pneumonia. Arch. Intern. Med.161, 1529–1533 (2001).
  • Benfield T, Atzori C, Miller RF, Helweg-Larsen J. Second-line salvage treatment of AIDS-associated Pneumocystis jirovecii pneumonia: a case series and systematic review. J. Acquir. Immune Defic. Syndr.48, 63–67 (2008).
  • Green H, Paul M, Vidal L, Leibovici L. Prophylaxis of Pneumocystis pneumonia in immunocompromised non-HIV-infected patients: systematic review and meta-analysis of randomized controlled trials. Mayo Clin. Proc.82, 1052–1059 (2007).
  • Di Cocco P, Orlando G, Bonanni L et al. A systematic review of two different trimetoprim–sulfamethoxazole regimens used to prevent Pneumocystis jirovecii and no prophylaxis at all in transplant recipients: appraising the evidence. Transplant. Proc.41, 1201–1203 (2009).
  • Podzamczer D, Salazar A, Jimenez J et al. Intermittent trimethoprim–sulfamethoxazole compared with dapsone–pyrimethamine for the simultaneous primary prophylaxis of Pneumocystis pneumonia and toxoplasmosis in patients infected with HIV. Ann. Intern. Med.122, 755–761 (1995).
  • El-Sadr WM, Murphy RL, Yurik TM et al. Atovaquone compared with dapsone for the prevention of Pneumocystis carinii pneumonia in patients with HIV infection who cannot tolerate trimethoprim, sulfonamides, or both. N. Engl. J. Med.339, 1889–1895 (1998).
  • Yale SH, Limper AH. Pneumocystis carinii pneumonia in patients without acquired immunodeficiency syndrome: associated illness and prior corticosteroid therapy. Mayo Clin. Proc.71, 5–13 (1996).
  • Sowden E, Carmichael AJ. Autoimmune inflammatory disorders, systemic corticosteroids and Pneumocystis pneumonia: a strategy for prevention. BMC Infect. Dis.4, 42 (2004).
  • Lemaire CM, Browning JC, Hsu S. Medical pearl: Pneumocystis pneumonia prophylaxis for patients on chronic systemic corticosteroids. J. Am. Acad. Dermatol.55, 124–125 (2006)
  • Langford CA, Talar-Williams C, Barron KS, Sneller MC. Use of cyclophosphamide-induction methotrexate-maintenance regimen for the treatment of Wegener’s granulomatosis: extended follow-up and rate of relapse. Am. J. Med.114, 463–469 (2003).
  • Wegener’s Granulomatosis Etanercept Trial (WGET) Research Group. Etanercept plus standard therapy for Wegener’s granulomatosis. N. Engl. J. Med.352, 351–361 (2005).
  • Lopez Bernaldo de Quiros JC, Miro JM, Peña JM et al. A randomized trial of the discontinuation of primary and secondary prophylaxis against Pneumocystis carinii pneumonia after highly active antiretroviral therapy in patients with HIV infection. N. Engl. J. Med.344, 159–167 (2001).
  • Vargas SL, Hughes WT, Santolaya ME et al. Search for primary infection by Pneumocystis carinii in a cohort of normal, healthy infants. Clin. Infect. Dis.32, 855–861 (2001).
  • Totet A, Latouche S, Lacube P et al. Pneumocystis jirovecii dihydropteroate synthase genotypes in immunocompetent infants and immunosuppressed adults, Amiens, France. Emerg. Infect. Dis.10, 667–673 (2004).
  • Larsen HH, von Linstow ML, Lundgren B, Hogh B, Westh H, Lundgren JD. Primary Pneumocystis infection in infants hospitalized with acute respiratory tract infection. Emerg. Infect. Dis.13, 66–72 (2007).
  • Dei-Cas E. Pneumocystis infections: the iceberg? Med. Mycol.38(Suppl. 1), 23–32 (2000).
  • Vargas SL, Ponce CA, Sanchez CA, Ulloa AV, Bustamante R, Juarez G. Pregnancy and asymptomatic carriage of Pneumocystis jiroveci. Emerg. Infect. Dis.9, 605–606 (2003).
  • Montes-Cano MA, Chabe M, Fontillon-Alberdi M et al. First molecular evidence of Pneumocystis jirovecii vertical transmission in human. Emerg. Infect. Dis.15, 125–127 (2009).
  • Gigliotti F, Harmsen AG, Haidaris CG, Haidaris PJ. Pneumocystis carinii is not universally transmissible between mammalian species. Infect. Immun.61, 2886–2890 (1993).
  • Aliouat EM, Mazars E, Dei-Cas E, Delcourt P, Billaut P, Camus D. Pneumocystis cross infection experiments using SCID mice and nude rats as recipient host, showed strong host-species specificity. J. Eukaryot. Microbiol.41, 71S (1994).
  • Banerji S, Lugli EB, Miller RF, Wakefield AE. Analysis of genetic diversity at the arom locus in isolates of Pneumocystis carinii. J. Eukaryot. Microbiol.42, 675–679 (1995).
  • Mazars E, Odberg-Ferragut C, Dei-Cas E et al. Polymorphism of the thymidylate synthase gene of Pneumocystis carinii from different host species. J. Eukaryot. Microbiol.42, 26–32 (1995).
  • Atzori C, Agostoni F, Angeli E, Mainini A, Micheli V, Cargnel A. P. carinii host specificity: attempt of cross infections with human derived strains in rats. J. Eukaryot. Microbiol.46, 112S (1999).
  • Denis CM, Mazars E, Guyot K et al. Genetic divergence at the SODA locus of six different formae speciales of Pneumocystis carinii. Med. Mycol.38, 289–300 (2000).
  • Durand-Joly I, Aliouat EM, Recourt C et al.Pneumocystis carinii f. sp. hominis is not infectious to SCID mice. J. Clin. Microbiol.40, 1862–1865 (2002).
  • Rivero L, de la Horra C, Montes-Cano MA et al.Pneumocystis jirovecii transmission from immunocompetent carriers to infant. Emerg. Infect. Dis.14, 1116–1118 (2008).
  • Schmoldt S, Schuhegger R, Wendler T et al. Molecular evidence of nosocomial Pneumocystis jirovecii transmission among 16 patients after kidney transplantation. J. Clin. Microbiol.46, 966–971 (2008).
  • Yazaki H, Goto N, Uchida K, Kobayashi T, Gatanaga H, Oka S. Outbreak of Pneumocystis jiroveci pneumonia in renal transplant recipients: P. jiroveci is contagious to the susceptible host. Transplantation88, 380–385 (2009).
  • Haidaris PJ, Wright TW, Gigliotti F, Fallon MA, Whitbeck AA, Haidaris CG. In situ hybridization analysis of developmental stages of Pneumocystis carinii that are transcriptionally active for a major surface glycoprotein gene. Mol. Microbiol.7, 647–656 (1993).
  • Hopkins JM, Wakefield AE. Pneumocystis carinii. In: Molecular and Cell Biology of Opportunistic Infections in AIDS. Myint S, Cann A (Eds). Chapman & Hall, London, UK, 187–203 (1993).
  • Kobayashi M, Urata T, Ikezoe T et al. Simple detection of the 5S ribosomal RNA of Pneumocystis carinii using in situ hybridisation. J. Clin. Pathol.49, 712–716 (1996).
  • Ramos-Vara JA, Lu JJ, da Silva AJ et al. Characterization of natural occurring Pneumocystis carinii pneumonia in pigs by histopathology, electron microscopy, in situ hybridization and PCR amplification. Histol. Histopathol.13, 129–136 (1998).
  • Jensen TK, Boye M, Bille-Hansen V. Application of fluorescent in situ hybridization for specific diagnosis of Pneumocystis carinii pneumonia in foals and pigs. Vet. Pathol.38, 269–274 (2001).
  • Tsongalis GJ, McPhail AH, Lodge-Rigal RD, Chapman JF, Silverman LM. Localized in situ amplification (LISA): a novel approach to in situ PCR. Clin. Chem.40, 381–384 (1994).
  • Huang L, Crothers K, De Oliveira A et al. Application of an mRNA-based molecular viability assay to oropharyngeal washes for the diagnosis of Pneumocystis pneumonia in HIV-infected patients. A pilot study. J. Eukaryot. Microbiol.50(Suppl.), 618–620 (2003).
  • De Oliveira A, Unnasch TR, Crothers K et al. Performance of a molecular viability assay for the diagnosis of Pneumocystis pneumonia in HIV-infected patients. Diagn. Microbiol. Infect. Dis.57, 169–176 (2007).
  • Aviles P, Aliouat EM, Martinez A et al.In vitro pharmacodynamic parameters of sordarin derivatives in comparison with atovaquone, pentamidine and trimethoprim/sulfamethoxazol against rat-derived Pneumocystis carinii. Antimicrob. Agents Chemother.44, 1284–1290 (2000).
  • Cushion MT, Walzer PD. Preclinical drug discovery for new anti-Pneumocystis compounds. Curr. Med. Chem.16, 2514–2530 (2009).
  • Herreros E, Martinez CM, Almela MJ, Marriott MS, De Las Heras FG, Gargallo-Viola D. Sordarins: in vitro activities of new antifungal derivatives against pathogenic yeasts, Pneumocystis carinii, and filamentous fungi. Antimicrob. Agents Chemother.42, 2863–2869 (1998).
  • Aviles P, Aliouat EM, Martinez A et al.In vitro pharmacodynamic parameters of sordarin derivatives in comparison with those of marketed compounds against Pneumocystis carinii isolated from rats. Antimicrob. Agents Chemother.44, 1284–1290 (2000).
  • Powles MA, Liberator P, Anderson J et al. Efficacy of MK-991 (L-743,872), a semisynthetic Pneumocandin, in murine models of Pneumocystis carinii. Antimicrob. Agents Chemother.42, 1985–1989 (1998).
  • Utili R, Durante-Mangoni E, Basilico C, Mattei A, Ragone E, Grossi P. Efficacy of caspofungin addition to trimethoprim–sulfamethoxazole treatment for severe pneumocystis pneumonia in solid organ transplant recipients. Transplantation84, 685–688 (2007).
  • Xiang-dong MU, Cheng-li QUE, Bing HE, Wang Guang-fa, Hai-chao LI. Caspofungin in salvage treatment of severe Pneumocystis pneumonia: case report and literature review. Chin. Med. J. (Engl.)122, 996–999 (2009).
  • Gigliotti F, Hughes WT. Passive immunoprophylaxis with specific monoclonal antibody confers partial protection against Pneumocystis carinii pneumonitis in animal models. J. Clin. Invest.81, 1666–1668 (1988).
  • Bartlett MS, Angus WC, Shaw MM et al. Antibody to Pneumocystis carinii protects rats and mice from developing pneumonia. Clin. Diagn. Lab. Immunol.5, 74–77 (1998).
  • Zheng M, Shellito JE, Marrero L et al. CD4+ T cell-independent vaccination against Pneumocystis carinii in mice. J. Clin. Invest.108, 1469–1474 (2001).
  • Garvy BA, Wiley JA, Gigliotti F, Harmsen AG. Protection against Pneumocystis carinii pneumonia by antibodies generated from either T helper 1 or T helper 2 responses. Infect. Immun.65, 5052–5056 (1997).
  • Smulian AG, Sullivan DW, Theus SA. Immunization with recombinant Pneumocystis carinii p55 antigen provides partial protection against infection: characterization of epitope recognition associated with immunization. Microbes Infect.2, 127–136 (2000).
  • Wells J, Haidaris CG, Wright TW, Gigliotti F. Active immunization against Pneumocystis carinii with a recombinant P. carinii antigen. Infect. Immun.74, 2446–2448 (2006).

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