A comprehensive clinical guide for Pneumocystis jirovecii pneumonia: a missing therapeutic target in HIV-uninfected patients.

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM
Ahmad R Alsayed, Abdullah Al-Dulaimi, Mohammad Alkhatib, Mohammed Al Maqbali, Mohammad A A Al-Najjar, Mamoon M D Al-Rshaidat
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引用次数: 8

Abstract

Introduction: Pneumocystis jirovecii is an opportunistic, human-specific fungus that causes Pneumocystis pneumonia (PCP). PCP symptoms are nonspecific. A patient with P. jirovecii and another lung infection faces a diagnostic challenge. It may be difficult to determine which of these agents is responsible for the clinical symptoms, preventing effective treatment. Diagnostic and treatment efforts have been made more difficult by the rising frequency with which coronavirus 2019 (COVID-19) and PCP co-occur.

Areas covered: Herein, we provide a comprehensive review of clinical and pharmacological recommendations along with a literature review of PCP in immunocompromised patients focusing on HIV-uninfected patients.

Expert opinion: PCP may be masked by identifying co-existing pathogens that are not necessarily responsible for the observed infection. Patients with severe form COVID-19 should be examined for underlying immunodeficiency, and co-infections must be considered as co-infection with P. jirovecii may worsen COVID-19's severity and fatality. PCP should be investigated in patients with PCP risk factors who come with pneumonia and suggestive radiographic symptoms but have not previously received PCP prophylaxis. PCP prophylaxis should be explored in individuals with various conditions that impair the immune system, depending on their PCP risk.

一个全面的临床指南的肺囊虫肺炎:一个缺失的治疗目标,在hiv未感染的患者。
乙氏肺囊虫是一种机会性的、人类特有的真菌,可引起肺囊虫性肺炎(PCP)。PCP症状是非特异性的。一名同时感染耶氏疟原虫和另一种肺部感染的患者面临着诊断上的挑战。可能很难确定这些药物中的哪一种导致了临床症状,从而妨碍了有效的治疗。由于冠状病毒2019 (COVID-19)和PCP同时发生的频率越来越高,诊断和治疗工作变得更加困难。涵盖领域:在此,我们提供了临床和药理学建议的综合综述,以及免疫功能低下患者PCP的文献综述,重点是hiv未感染患者。专家意见:PCP可能通过识别共存的病原体而被掩盖,这些病原体不一定对观察到的感染负责。重症COVID-19患者应检查是否存在潜在的免疫缺陷,必须考虑合并感染,因为与耶氏疟原虫合并感染可能会加重COVID-19的严重程度和病死率。有PCP危险因素的患者,如果伴有肺炎和影像学提示症状,但之前未接受过PCP预防治疗,应调查PCP。应根据个体的PCP风险,对各种损害免疫系统的个体进行PCP预防。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
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