肺孢子菌肺炎。

Q3 Medicine
Svatava Snopková, Radek Svačinka, David Vydrář, Petr Husa, Tereza Kopřivová, Jakub Vlažný, Petr Husa
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引用次数: 0

摘要

在引进现代治疗和药理学干预措施,成功地解决了许多以前被认为与生命不相容的疾病和病症的同时,患有继发性免疫缺陷的患者人数也显著增加。因此,这些病人极易受到各种机会性感染。在这些感染中,肺囊虫性肺炎(PCP)是最常见和可能危及生命的感染之一,需要及时诊断和治疗。观察性研究清楚地表明,PCP影响越来越多的具有各种潜在疾病和导致免疫系统功能障碍的不同风险特征的患者。高危患者的人数和这些疾病的范围继续扩大。令人惊讶的是,这种诊断现在被建立在最初不被认为有风险的人群中,例如接受慢性糖皮质激素治疗的患者。这种疾病通常未被诊断,并导致各种原发疾病患者相对较高的致命结果。本文综述了HIV感染者和非HIV感染者PCP的基本流行病学因素、危险因素、推测的病理生理学、目前的诊断选择、PCP的典型临床病程,以及PCP的预防和治疗。值得注意的是,在大多数严重免疫缺陷患者中,多种药物同时参与引起感染性并发症。巨细胞病毒合并感染是PCP的常见并发症。在多重感染同时发生的情况下,如果合并感染未被识别和治疗,则可能使PCP的治疗看起来无效。因此,在初步诊断时注意潜在的合并感染是至关重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Pneumocystis pneumonia].

In parallel with the introduction of modern therapeutic and pharmacological interventions that have successfully resolved many diseases and conditions, previously deemed incompatible with life, there has been a significant increase in the number of patients experiencing secondary immunodeficiency. As a result, these patients are highly susceptible to various opportunistic infections. Among these infections, pneumocystis pneumonia (PCP) stands out as one of the most frequent and potentially life-threatening ones, necessitating prompt diagnosis and treatment. Observational studies have clearly shown that PCP affects an increasing number of patients with diverse underlying diseases and varying risk profiles that lead to immune system dysfunction. The population of at-risk patients and the range of these conditions continue to expand. Surprisingly, the diagnosis is now established in populations that were not initially considered at risk, such as patients on chronic glucocorticoid therapy. This disease often remains undiagnosed and contributes to a relatively high number of fatal outcomes in patients with various primary diseases. The text summarizes the basic epidemiological factors, risk factors, presumed pathophysiology, current diagnostic options, and typical clinical course of PCP in patients living with HIV and non-HIV patients, as well as the prophylaxis and treatment of PCP. It is important to note that in most patients with severe immunodeficiency, multiple agents are involved simultaneously in causing infectious complications. Coinfection with cytomegalovirus is a very common complication of PCP. In the context of multiple infections occurring simultaneously, if a coinfection goes unrecognized and untreated, it can render the treatment of PCP seemingly ineffective. Therefore, it is crucial to pay attention to potential coinfections already during the primary diagnosis.

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来源期刊
Klinicka mikrobiologie a infekcni lekarstvi
Klinicka mikrobiologie a infekcni lekarstvi Medicine-Infectious Diseases
CiteScore
0.40
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