PNEUMOCYSTIS CHRONIOSEPSIS AS AN OPTION OF PNEUMOCYSTIS INFECTION PROGRESSION: CASE REPORT

V. Gerasimov, E. Slesareva, Tat'yana Kuznetsova, Ya.S. Abuzova
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Abstract

Pneumocystis infection caused by Pneumocystis jiroveci tops the list of opportunistic infections, affecting mainly premature babies and people with various types of immunodeficiency disorders. Generalized forms of the disease in immunocompromised patients are extremely rare and do not have any pathognomonic symptoms, which often makes timely diagnosis and treatment difficult. The aim of the paper is to study clinical and morphological manifestations of generalized pneumocystosis and to clarify some aspects of its differential diagnosis as illustrated by an autopsy case. Materials and Methods. For histomorphological examination, autopsies of the liver, lung, pancreas, red bone marrow, brain, heart, and spleen were fixed in 10 % neutral formalin and embedded in paraffin. Sections of standard thickness were stained with hematoxylin-eosin; then histologic specimen were studied under a light microscope. The results of the histomorphological study were analyzed along with the medical history. Results. It has been shown that the following nonspecific clinical manifestations were specifically attributed to the generalized form of pneumocystosis: febrile fever, intoxication, non-productive cough, shortness of breath on little exertion, increased levels of hepatic transaminases, and leukocytosis. Histological manifestations included pneumocystis foci at different stages of development both in the parenchyma and in the interstitium of many internal organs, such as the liver, kidneys, spleen, brain, red bone marrow, lungs, and uterus. The preservation of the organ histoarchitectonics depended on the number of pneumocystis foci and the degree of organ damage. Conclusion. The generalized form of pneumocystis infection is very rare and it can be combined with other concomitant diseases. Moreover, it is characterized by a long asymptomatic period and complexity of laboratory diagnostics, so its mortality constantly increases. Generalized form of pneumocystis infection should be differentiated from acute respiratory diseases, cytomegalovirus infection, mycoplasmosis, chlamydia, toxoplasmosis, tuberculosis, sarcoidosis, neoplastic diseases, lymphogranulomatosis, and collagenoses, where the most precise methods are ELISA, indirect immunofluorescence test, immunofluorescence test, and PCR.
肺囊虫慢性败血症作为肺囊虫感染进展的一种选择:病例报告
由氏肺囊虫引起的肺囊虫感染是机会性感染的首选,主要影响早产儿和患有各种免疫缺陷疾病的人。在免疫功能低下的患者中,广泛性形式的疾病极为罕见,没有任何病理症状,这往往使及时诊断和治疗变得困难。本文的目的是研究广泛性肺囊虫病的临床和形态学表现,并阐明其鉴别诊断的一些方面,并以尸检病例为例。材料与方法。为了进行组织形态学检查,将肝脏、肺、胰腺、红骨髓、脑、心脏和脾脏的尸体用10%中性福尔马林固定,并用石蜡包埋。标准厚度切片用苏木精-伊红染色;光镜下观察组织学标本。结合病史对组织形态学研究结果进行分析。结果。有研究表明,以下非特异性临床表现可特别归因于肺囊虫病的一般形式:发热、中毒、无生产性咳嗽、轻微用力时呼吸短促、肝转氨酶水平升高和白细胞增多。组织学表现为肝、肾、脾、脑、红骨髓、肺、子宫等许多脏器的实质和间质均有不同发展阶段的局灶性肺囊虫。脏器组织结构的保存取决于肺囊虫病灶的数量和脏器损伤的程度。结论。肺囊虫感染的广泛性形式是非常罕见的,它可以与其他伴随疾病合并。且无症状期长,实验室诊断复杂,死亡率不断上升。广义肺囊虫感染应与急性呼吸道疾病、巨细胞病毒感染、支原体病、衣原体病、弓形虫病、结核病、结节病、肿瘤性疾病、淋巴肉芽肿病、胶原蛋白病相鉴别,其中最精确的方法是ELISA、间接免疫荧光试验、免疫荧光试验和PCR。
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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