Pneumocystis jirovecii

Pneumocystis jirovecii is an atypical fungus, it appears to be widespread because a significant proportion of the population has antibodies to this microorganism. However, symptomatic manifestations only occur in people with defective cellular immunity. Therefore, a high incidence of pneumonia caused by P. jirovecii is observed in patients on immunosuppressive therapy and in people with HIV.

Diagnostics
Symptoms are non-specific and may resemble a number of other infectious and non-infectious respiratory diseases.

The organism cannot be isolated from coughed sputum using conventional culture methods and therefore invasive techniques such as open lung biopsy or bronchoalveolar lavage are required. In such material, the organism may be highlighted by silver staining or immunofluorescence. DNA amplification by PCR increases the sensitivity of the test.

Therapy
Usually high doses of cotrimoxazole. An alternative is pentamidine.

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