Pneumocystis pneumonia represents a potentially life-threatening infection caused by a fungal microorganism Pneumocystis jiroveci. Initially observed in premature and malnourished infants, Pneumocystis pneumonia is today one of the most frequent opportunistic infections in adults infected with human immunodeficiency virus (HIV).
As nonspecific symptoms are often hindering timely diagnosis, one of the most important diagnostic tools for Pneumocystis pneumonia is a high level of clinical suspicion. Clinicians should always consider this diagnosis in HIV-infected patients that complain of shortness of breath, nonproductive cough and/or fever. Microbiological and molecular methods are then employed as a step towards a final diagnosis.
Microbiological …show more content…
A predilection for the upper parts of the lungs has also been described as a characteristic sign.
Serum markers
Although serum β-D-glucan (which is a part of the cell wall of Pneumocystis and other fungi) is not specific for Pneumocystis infections, the measurement of its level has been used as a useful tool in the diagnosis of Pneumocystis pneumonia, or at least in the screening for the disease.
However, it must be noted that false-positive results can arise due to certain factors such as bacteremia, hemodialysis, certain antimicrobial drugs and the administration of immunoglobulin. In addition, the cut-off value that can be used in the diagnosis of Pneumocystis pneumonia still needs to be determined.
Krebs von den Lungen-6 (abbreviated as KL-6) is another marker that is expressed on pneumocytes and epithelial cells of the bronchi, which acts as a sensitive indicator of different types of interstitial pneumonitis. Therefore in cases of Pneumocystis pneumonia, this marker is elevated as a result of injury and subsequent regeneration of alveolar epithelial
As nonspecific symptoms are often hindering timely diagnosis, one of the most important diagnostic tools for Pneumocystis pneumonia is a high level of clinical suspicion. Clinicians should always consider this diagnosis in HIV-infected patients that complain of shortness of breath, nonproductive cough and/or fever. Microbiological and molecular methods are then employed as a step towards a final diagnosis.
Microbiological …show more content…
A predilection for the upper parts of the lungs has also been described as a characteristic sign.
Serum markers
Although serum β-D-glucan (which is a part of the cell wall of Pneumocystis and other fungi) is not specific for Pneumocystis infections, the measurement of its level has been used as a useful tool in the diagnosis of Pneumocystis pneumonia, or at least in the screening for the disease.
However, it must be noted that false-positive results can arise due to certain factors such as bacteremia, hemodialysis, certain antimicrobial drugs and the administration of immunoglobulin. In addition, the cut-off value that can be used in the diagnosis of Pneumocystis pneumonia still needs to be determined.
Krebs von den Lungen-6 (abbreviated as KL-6) is another marker that is expressed on pneumocytes and epithelial cells of the bronchi, which acts as a sensitive indicator of different types of interstitial pneumonitis. Therefore in cases of Pneumocystis pneumonia, this marker is elevated as a result of injury and subsequent regeneration of alveolar epithelial