Presentation
A 28-year-old acquired immunodeficiency syndrome patient receiving prophylaxis with aerosolized pentamidine who presented with a solitary rectal ulcer is reported. [ncbi.nlm.nih.gov]
Immune System
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Generalized Lymphadenopathy
CASE: A case of generalized lymphadenopathy was referred to us for fine needle aspiration cytology (FNAC). The patient was a 9-year-old boy who had a toxic facies and manifested multiple skin lesions all over the body. [ncbi.nlm.nih.gov]
In 2007, a 9-year old HIV-infected boy presented with generalized lymphadenopathy and fine needle aspiration cytology showed extra-pulmonary Pneumocystis infection.7,15 P. jiroveci infection, the most common severe infection and particularly lethal in [scielo.br]
Entire Body System
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Asymptomatic
These patients had a spectrum of illness ranging from asymptomatic to severe pneumonia requiring mechanical ventilation. [ncbi.nlm.nih.gov]
A followup study of asymptomatic carriers of Pneumocystis jiroveci during immunosuppressive therapy for rheumatoid arthritis. J Rheumatol. 2009 Aug. 36(8):1600-5. [Medline]. Resnick IB, Averbuch D, Aker M, et al. [emedicine.medscape.com]
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Fatigue
The first signs of PCP are fever, dry cough, shortness of breath, and fatigue. If you have a weakened immune system and have these symptoms, see your doctor right away. [medlineplus.gov]
Dry cough or wheezing Shortness of breath Fatigue Chest pain or tightness when you breathe Chills Weight loss Symptoms usually come on slowly, over several weeks, in people who have HIV. [webmd.com]
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Peritoneal Effusion
effusions with subsequent calcifications of the pleural and peritoneal surfaces. [pubs.rsna.org]
effusion with subsequent calcification in the surface18 Enlarged heterogeneous spleen with innumerable, low attenuation, hypodense lesions; hepatomegaly; gallbladder wall thickening are some findings reported in extrapulmonary pnemocystosis, as well.15 [scielo.br]
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Constitutional Symptom
Life long primary prophylaxis is given to HIV positive individuals with CD4 lymphocyte counts 0.20 x 10(9)/L or a CD4: total lymphocyte ratio of 1.5, constitutional symptoms, or with other AIDS defining diseases. [ncbi.nlm.nih.gov]
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Sudden Infant Death Syndrome
This prompted us to analyze additional series of infants with sudden infant death syndrome (SIDS). [ncbi.nlm.nih.gov]
Respiratoric
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Aspiration
Fine needle aspiration diagnosis of EPC infection is a possibility in such cases with lymphadenopathy and must be included in the differential diagnosis of lymph node swellings in AIDS. [ncbi.nlm.nih.gov]
There was a pulmonary mass of which cytology was unrevealing and the diagnosis of P. jiroveci was made from sternal aspiration cytology. [scielo.br]
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Sputum Production
The patient denied any respiratory tract symptoms such as cough, sputum production, pleuritic chest pain, or shortness of breath. Chest X-ray revealed two large round noncavitating lesions in the lower lobe of the right lung. [ncbi.nlm.nih.gov]
Gastrointestinal
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Acute Abdomen
Abstract Perforation of the small intestine due to a segmental transmural Pneumocystis carinii infiltrate of the whole circumference was found in a surgical resection specimen as the cause of an acute abdomen in a 48-year-old heterosexual male patient [ncbi.nlm.nih.gov]
Musculoskeletal
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Decrease in Height
Decreased disc height at T11-T12 level was detected in chest X-ray. [scielo.br]
Eyes
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Conjunctival Disease
Conjunctival disease due to P. carinii widens the spectrum of AIDS-associated ophthalmic pneumocystosis. [ncbi.nlm.nih.gov]
Neurologic
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Confusion
This atypical manifestation caused significant diagnostic confusion. Recognition that P carinii infection can cause calcification of hilar and mediastinal lymph nodes may prevent this confusion and facilitate diagnosis and treatment. [ncbi.nlm.nih.gov]
Workup
Other Noninvasive Tests Pulmonary function tests Pulmonary function tests should be obtained as part of the initial noninvasive workup in patients with suspected P jiroveci pneumonia (PJP). [emedicine.medscape.com]
X-Ray
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Cavitary Lesion
Findings on chest roentgenograms included large thin-walled cavitarylike lesions, multiple cavitary lesions, or pneumothorax. [ncbi.nlm.nih.gov]
Proctoscopy
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Rectal Ulcer
A 28-year-old acquired immunodeficiency syndrome patient receiving prophylaxis with aerosolized pentamidine who presented with a solitary rectal ulcer is reported. [ncbi.nlm.nih.gov]
AIDS-related extrapulmonary Pneumocystis carinii infection presenting as a solitary rectal ulcer. Can J Gastroenterol. 1996;10:401-4. [ Links ] 6. Coker RJ, Clark D, Claydon EL, et al. Disseminated Pneumocystis carinii infection in AIDS. [scielo.br]
Serum
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Liver Enzymes Abnormal
We present a well-documented case of P. carinii involving the liver in an AIDS patient with P. carinii pneumonia and progressive liver enzyme abnormalities. [ncbi.nlm.nih.gov]
Colonoscopy
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Polyps
We report a case of P carinii infection presenting as bilateral aural polyps, otitis media and mastoiditis in human immunodeficiency (HIV)-positive patient with no history of prior or concomitant P carinii infection. [ncbi.nlm.nih.gov]
Biopsy
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Liver Biopsy
We report such an occurrence in a patient with persistent elevation of alkaline phosphatase and gamma-glutamyl transpeptidase with relatively normal transaminases who was found to have P. carinii on antemortem liver biopsy. [ncbi.nlm.nih.gov]
Treatment
This paper reviews the standard treatments for P. carinii pneumonia, some of the newer agents such as atovaquone, recently licensed in the U.K., and a variety of novel agents being assessed for treatment and prophylaxis. [ncbi.nlm.nih.gov]
Prognosis
What is the prognosis in pneumocystosis? Early diagnosis and treatment of pneumocystosis increase the likelihood of successful treatment. In patients with HIV infection, around 10–20% of cases will be fatal. [dermnetnz.org]
Treatment and prognosis Most patients with acute infection are treated with trimethoprim-sulfamethoxazole (co-trimoxazole or TMP-SMZ), combined with corticosteroids in patients with moderate to severe infections 8. [radiopaedia.org]
This greatly diminishes the prognosis. [emedicine.medscape.com]
Prognosis of human immunodeficiency virus infection in children and adolescents. Pediatr Infect Dis J 1989;8:216-20. Maldonado YA, Araneta RG, Hersch AL, et al. [medigraphic.com]
Etiology
We present the case of an AIDS patient who had massive cervical pneumocystis lymphadenitis and minimal pulmonary infiltrates of undetermined etiology and a clinical picture of severe wasting and fever of unknown origin. [ncbi.nlm.nih.gov]
The organism is found in 3 distinct morphologic stages, as follows: The trophozoite (trophic form), in which it often exists in clusters The sporozoite (precystic form) The cyst, which contains several intracystic bodies (spores) Pathophysiology and Etiology [emedicine.medscape.com]
A etiology and outcome of pneumonia in human immunodeficiency virus-infected children hospitalized in South Africa. Acta Paediatr 2001;90:119-25. Graham SM, Mtitimila EI, Kamanga HS, et al. [medigraphic.com]
Epidemiology
Siani Hospital, Los Angeles; Field services Div, Epidemiology Program Office, CDC. Editorial Note: Pneumocystis pneumonia in the United States is almost exclusively limited to severely immunosuppressed patients (1). [cdc.gov]
Pneumocystis jiroveciinfection: a case report aPediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran bClinical Tuberculosis and Epidemiology [scielo.br]
Pneumocystis carinii is a continued cause of opportunistic infection, but our understanding of its transmission and epidemiology is rudimentary (1). [atsjournals.org]
Epidemiology, clinical manifestations, and diagnosis of Pneumocystis pneumonia in HIV-uninfected patients. UpToDate. Oct 03, 2017. Accessed April 24, 2018. Pneumocystis pneumonia. Centers for Disease Control and Prevention. Published April 26, 2017. [rarediseases.org]
These new treatment schedules have changed the epidemiology of opportunistic infections that previous to use of highly active antiretroviral therapy (HAART), fomerly occurred with high frequency in HIV-infected children. [medigraphic.com]
Pathophysiology
The organism is found in 3 distinct morphologic stages, as follows: The trophozoite (trophic form), in which it often exists in clusters The sporozoite (precystic form) The cyst, which contains several intracystic bodies (spores) Pathophysiology and Etiology [emedicine.medscape.com]
Prevention
Recognition that P carinii infection can cause calcification of hilar and mediastinal lymph nodes may prevent this confusion and facilitate diagnosis and treatment. [ncbi.nlm.nih.gov]
There is no vaccine to prevent PCP. Some people who are at high risk of getting PCP may need to take antibiotics to prevent it. [medlineplus.gov]
Can Pneumocystis Pneumonia Be Prevented? No vaccine can prevent PCP. But people with HIV/AIDS or other conditions that weaken the immune system can take antibiotics to prevent pneumocystis infection. [kidshealth.org]
Centers for Disease Control and Prevention. 1999 USPHS/IDSA Guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency. MMWR 1999;48(RR10):1-59. Principi N, Marchisio P, Onorato J, et al. [medigraphic.com]