TY  - CHAP
M1  - Book, Section
TI  - Pneumocystis Pneumonia
A1  - Nussbaum, Eliezer Zachary
A1  - Azar, Marwan M.
A2  - Grippi, Michael A.
A2  - Antin-Ozerkis, Danielle E.
A2  - Dela Cruz, Charles S.
A2  - Kotloff, Robert M.
A2  - Kotton, Camille Nelson
A2  - Pack, Allan I.
PY  - 2023
T2  - Fishman’s Pulmonary Diseases and Disorders, 6e
AB  - Pneumocystis  is  an  opportunistic  yeast-like  fungus  that  is  tropic  to  mammalian  lung  tissue  and  produces  a  clinical  spectrum  ranging  from  asymptomatic  infection  to  subacute  and  acute  interstitial  pneumonia  in  susceptible  hosts.  The  earliest  descriptions  of  Pneumocystis  jiroveci  pneumonia  (PCP)  in  humans  came  from  reports  of  malnourished  children  and  neonates  with  pneumonia  in  the  1940s,  but  the  syndrome  came  into  worldwide  prominence  during  the  HIV/AIDS  pandemic  in  the  1980s  where  PCP  accounted  for  more  than  one-fourth  of  community-acquired  pneumonias  in  persons  living  with  HIV/AIDS  (PLWH).  The  subsequent  introduction  of  combination  antiretroviral  therapy  (ART)  and  institution  of  routine  PCP  prophylaxis  for  those  at  greatest  risk  of  infection  led  to  a  decreased  incidence  of  PCP  among  PLWH.  In  the  developed  world,  HIV-negative  patients  with  cell-mediated  immune  deficiencies  have  become  the  most  common  hosts  for  PCP,  with  60%  to  70%  of  new  infections  occurring  in  patients  on  prolonged  high-dose  corticosteroids  and  chemotherapeutic  agents  as  well  as  those  with  autoimmune  diseases  or  recipients  of  solid  organ  or  hematopoietic  stem  cell  transplantation.1–3  Although  it  produces  a  characteristic  interstitial  pneumonia  for  which  effective  treatments  are  available,  Pneumocystis  jiroveci  has  remained  a  problematic  pathogen  due  to  an  enlarging  population  of  at-risk  individuals,  a  propensity  to  colonize  hosts  for  short  periods  of  time  without  necessarily  causing  infection,  an  ability  to  produce  fulminant  infection  despite  low  pathogen  burdens,  intrinsic  resistance  to  the  most  common  antifungal  classes,  and  the  inability  to  sustain  and  thus  study  the  organism  in  vitro.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1205985167
ER  -