680 results match your criteria Pneumocystis Carinii Imaging

Pneumocystis pneumonia causing cavitating lung nodules in an immunocompetent individual.

BMJ Case Rep 2021 Apr 27;14(4). Epub 2021 Apr 27.

Respiratory Medicine, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

Pneumocystis jirovecii pneumonia (PCP) is a potential life-threatening pulmonary infection which commonly manifests in immunosuppressed patients especially with HIV, with underlying malignancies, severe malnutrition as well as those on immunosuppressive treatments. There have been case reports of symptomatic PCP in individuals with a normally functioning immune system with typical clinical features and radiologic findings of bilateral and diffuse interstitial opacities. However, PCP in immunocompetent individuals presenting with lung nodules had been rarely reported. Read More

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Unusual aetiology of respiratory compromise in a patient with AIDS.

BMJ Case Rep 2021 Mar 23;14(3). Epub 2021 Mar 23.

Internal Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA.

A 36-year-old African American man with no medical history presented with a recent history of cough and dyspnoea. Initial chest imaging revealed diffuse bilateral lung infiltrates. A subsequent HIV test resulted positive, and he was presumptively diagnosed with AIDS, later confirmed by a CD4 of 88 cells/mm Empiric therapy with trimethoprim-sulfamethoxazole was initiated for presumed pneumonia. Read More

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Increased mRNA expression of key cytokines among suspected cases of Pneumocystis jirovecii infection.

BMC Infect Dis 2021 Jan 7;21(1):28. Epub 2021 Jan 7.

Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, Saudi Arabia.

Background: Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokine mRNA expression among suspected P. Read More

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January 2021

Panniculitis in a Woman With Opportunistic Pulmonary Coinfection by Pneumocystis jirovecii and Cryptococcus neoformans: 18F-FDG PET/CT Revealing the Infection and Assessing Treatment Response.

Clin Nucl Med 2021 Apr;46(4):e210-e211

Pneumology, Rouen University Hospital.

Abstract: A 56-year-old woman, with history of psoriasis well controlled on ustekinumab, underwent 18F-FDG PET/CT to explore first onset of histologically proven skin panniculitis of unknown origin. PET/CT showed high uptake in panniculitis lesions in limbs and in a lung opacity suggestive of pneumonia. Based on PET/CT findings, a bronchoalveolar lavage revealed pulmonary coinfection by Pneumocystis jirovecii and Cryptococcus neoformans. Read More

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Clinical features and treatment outcomes of human immunodeficiency virus-associated cryptococcal meningitis: a 2-year retrospective analysis.

Chin Med J (Engl) 2020 Dec;133(23):2787-2795

Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.

Background: Cryptococcal meningitis (CM) is one of the most common opportunistic infections caused by Cryptococcus neoformans in human immunodeficiency virus (HIV)-infected patients, and is complicated with significant morbidity and mortality. This study retrospectively analyzed the clinical features, characteristics, treatment, and outcomes of first-diagnosed HIV-associated CM after 2-years of follow-up.

Methods: Data from all patients (n = 101) of HIV-associated CM hospitalized in Shanghai Public Health Clinical Center from September 2013 to December 2016 were collected and analyzed using logistic regression to identify clinical and microbiological factors associated with mortality. Read More

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December 2020

pneumonia, a COVID-19 mimic, reminds us of the importance of HIV testing in COVID-19.

Clin Med (Lond) 2020 11;20(6):590-592

University of Liverpool, Liverpool, UK and Royal Liverpool Hospital, Liverpool, UK

While clinical environments are highly focused on COVID-19, reports of missed or delayed treatment for conditions that imitate COVID-19, such as pneumonia caused by the fungus , are emerging. Given the uncertain spectrum of COVID-19 presentations and variable sensitivity of laboratory tests for SARS-CoV-2, there is a risk that, without a high index of suspicion, alternative aetiologies may be overlooked while pursuing a diagnosis of COVID-19. The British HIV Association has been calling for the inclusion of HIV testing in all patients admitted to hospital with suspected COVID-19. Read More

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November 2020

Bilateral pleural masses in an immunocompromised patient.

BMJ Case Rep 2020 Nov 4;13(11). Epub 2020 Nov 4.

Office of Faculty and Academic Affairs, University of Central Florida College of Medicine, Orlando, Florida, USA.

We present a case of persistent pleural masses with mediastinal adenopathy in an immunocompromised patient initially biopsied, diagnosed and treated for pneumonia, ultimately requiring surgical thoracoscopy to diagnose pulmonary histoplasmosis. We discuss the diagnostic approach for pleural masses in immunocompromised patients, the limitations of tissue sampling, interpretation and methodology, and pitfalls of testing in making a pathogen-specific diagnosis. Read More

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November 2020

Next-generation sequencing technology for detecting pulmonary fungal infection in bronchoalveolar lavage fluid of a patient with dermatomyositis: a case report and literature review.

BMC Infect Dis 2020 Aug 17;20(1):608. Epub 2020 Aug 17.

Department of Infectious Diseases, the First Hospital, Jilin University, Changchun, 130021, Jilin, China.

Background: Invasive fungal pneumonia is a severe infectious disease with high mortality in immunocompromised patients. However, the clinical diagnosis of the pathogen(s) remains difficult since microbiological evidence is difficult to acquire.

Case Presentation: Here, we report a case of pulmonary fungal infection detected by next-generation sequencing (NGS) of bronchoalveolar lavage fluid (BALF) in a 61-year-old male with corticosteroid-treated dermatomyositis. Read More

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The many faces of interstitial pneumonia: a case of presumed SARS-CoV-2 infection.

Swiss Med Wkly 2020 06 11;150:w20312. Epub 2020 Jul 11.

Internal Medicine Department, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Switzerland / Pneumology Department, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Switzerland.

We present the case of an oncology patient admitted to our hospital during the current COVID-19 pandemic with clinical and radiological features strongly suggestive of interstitial pneumonia. Multiple laboratory tests were negative for SARS-CoV-2 (polymerase chain reaction testing of nasopharyngeal swabs, and of induced sputum and stool samples, investigation of serum immunoglobulins G and M). In the setting of an immunocompromised status due to recent chemotherapy cycles for lung adenocarcinoma and prolonged corticosteroid therapy (due to frequent exacerbations of chronic obstructive pulmonary disease in recent months), we actively searched for the pathological agent and found it to be Pneumocystis jirovecii. Read More

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A complex COVID-19 case with rheumatoid arthritis treated with tocilizumab.

Clin Rheumatol 2020 Sep 19;39(9):2797-2802. Epub 2020 Jun 19.

Department of Rheumatology and Immunology, Tongji Hospital, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, China.

Recurrences of COVID-19 were observed in a patient with long-term usage of hydroxychloroquine, leflunomide, and glucocorticoids due to her 30-year history of rheumatoid arthritis (RA). Tocilizumab was applied and intended to target both COVID-19 and RA. However, disease of this patient aggravated after usage of tocilizumab. Read More

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September 2020

Characterization of Pneumocystis jirovecii pneumonia at three tertiary comprehensive hospitals in southern China.

Braz J Microbiol 2020 Sep 3;51(3):1061-1069. Epub 2020 May 3.

Jiangxi Provincial Key Laboratory of Medicine, Clinical Laboratory of the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

Due to the increasing use of immunosuppressant therapy, Pneumocystis jirovecii pneumonia (PJP) has become an emerging concern in human immunodeficiency virus (HIV)-negative patients. In this study, we conducted a retrospective study of 96 hospitalized patients with PJP from January 2015 to June 2019 at three tertiary comprehensive hospitals in Southern China. Information was collected regarding patient demographics, clinical manifestations, risk factors, laboratory analyses, radiological images, and treatment outcomes. Read More

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September 2020

Opportunistic coinfection with and associated with idelalisib treatment in a patient with chronic lymphocytic leukaemia.

BMJ Case Rep 2020 Apr 29;13(4). Epub 2020 Apr 29.

Division of Infectious Diseases, University of California San Francisco, San Francisco, California, USA.

We describe a case of opportunistic coinfections with and following treatment with idelalisib, a phosphoinositide 3-kinase inhibitor, for chronic lymphocytic leukaemia. This is the first case of pulmonary coccidioidomycosis reported in association with idelalisib. We review challenges related to diagnosis of opportunistic infections in this context. Read More

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Veno-Venous Extracorporeal Membrane Oxygenation for Severe Pneumocystis jirovecii Pneumonia in an Immunocompromised Patient without HIV Infection.

Tohoku J Exp Med 2020 04;250(4):215-221

Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine.

Pneumocystis jirovecii pneumonia (PJP) occurs in immunocompromised hosts and is classified as PJP with human immunodeficiency virus (HIV) infection (HIV-PJP) and PJP without HIV infection (non-HIV PJP). Non-HIV PJP rapidly progresses to respiratory failure compared with HIV-PJP possibly due to the difference in immune conditions; namely, the prognosis of non-HIV PJP is worse than that of HIV PJP. However, the diagnosis of non-HIV PJP at the early stage is difficult. Read More

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Pneumocystis Jirovecii Pneumonia in Newly Diagnosed HIV Infection: A Challenging Case Report.

Turk Patoloji Derg 2020 ;1(1):246-250

Department of Pathology, Gazi University, School of Medicine, ANKARA, TURKEY.

Pneumocystis jirovecii is a potentially life-threatening opportunistic pathogen particularly affecting the lungs, mainly in immunosuppressed individuals and HIV-infected patients with a low CD4 cell count. A 50-year-old man presented with a 1-week history of pleuritic chest pain and fever. He was also hypoxic with oxygen saturation of 86% on room air. Read More

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December 2020

Ground-glass opacities accompanied by pulmonary cysts.

J Bras Pneumol 2020 Mar 2;46(2):e20190428. Epub 2020 Mar 2.

. Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil.

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Pneumocystis jirovecii infection of bilateral adrenal glands in an immunocompetent adult: a case report.

J R Coll Physicians Edinb 2019 09;49(3):222-224

117 B L Taneja Building, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi 110002, India,

Pneumocystis jirovecii (PJ) infection is one of the most common opportunistic infections occurring in patients with HIV/AIDS and other immunocompromised states. It is not known to cause clinically significant illness in immunocompetent hosts. We report a 48-year-old HIV-negative, diabetic male who presented with fever and adrenal insufficiency. Read More

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September 2019

Serum Soluble Interleukin-2 Receptor Is a Biomarker for Pneumocystis jirovecii Pneumonia among Patients with Rheumatoid Arthritis under Methotrexate Therapy.

Tohoku J Exp Med 2019 07;248(3):209-216

Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences.

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by systemic joint inflammation and may manifest as interstitial pneumonia (IP). Methotrexate (MTX) is one of the main therapeutic drugs used for RA, but MTX could cause severe side effects, including Pneumocystis jirovecii pneumonia (PCP) and IP. Owing to similar symptoms, it is sometimes difficult to discriminate MTX therapy-associated PCP (MTX-PCP) and MTX therapy-associated IP (MTX-IP). Read More

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Pneumocystis jirovecii pneumonia at chest High-resolution Computed Tomography (HRCT) in non-HIV immunocompromised patients: Spectrum of findings and mimickers.

Eur J Radiol 2019 Jul 1;116:116-127. Epub 2019 May 1.

Institute of Radiology, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria Integrata di Udine, p.le S. Maria della Misericordia 15, 33100, Udine, Italy. Electronic address:

Pneumocystis jirovecii pneumonia (PJP) has emerged as a main issue in non Human Immunodeficiency Virus (HIV) immunocompromised hosts, exposing patients to high mortality rates, especially when the diagnosis is delayed. Since microbiological confirmation is often unfeasible or difficult to obtain, High-resolution Computed Tomography (HRCT) represents a main tool for guiding the diagnosis in the appropriate clinical scenario. Nevertheless, radiologists must be aware that PJP at HRCT is a multifaceted process, with a variety of common and less frequent findings, along with a broad spectrum of infectious (e. Read More

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Potential role of CT-textural features for differentiation between viral interstitial pneumonias, pneumocystis jirovecii pneumonia and diffuse alveolar hemorrhage in early stages of disease: a proof of principle.

BMC Med Imaging 2019 05 21;19(1):39. Epub 2019 May 21.

Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.

Background: Pulmonary involvement is common in several infectious and non-infectious diagnostic settings. Imaging findings consistently overlap and are therefore difficult to differentiate by chest-CT. The aim of this study was to evaluate the role of CT-textural features(CTTA) for discrimination between atypical viral (respiratory-syncitial-virus(RSV) and herpes-simplex-1-virus (HSV1)), fungal (pneumocystis-jirovecii-pneumonia(PJP)) interstitial pneumonias and alveolar hemorrhage. Read More

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Managing Pulmonary Toxicities Associated with Immunotherapy: A Case Discussion.

Oncologist 2019 06 21;24(6):730-734. Epub 2019 Mar 21.

Columbia University Medical Center, New York New York, USA

Immunotherapy has changed the field of oncology around the world with the approval of immune checkpoint inhibitors for a number of tumor types over the last 5 years. However, immune-mediated adverse events can be challenging and difficult to treat, with one of the most dire consequences being immune-mediated pneumonitis. KEY POINTS: Rapid intervention and aggressive management for grade 3 or greater pneumonitisSlow taper of steroids and also recommend pneumocystis carinii pneumonia prophylaxisMonitor carefully for a pneumonitis flare with steroid taper, which can occur in the absence of resuming anti-programmed cell death protein 1 (PD-1) [1], and do not resume anti-PD-1 therapy until completely off steroids and no clinical or radiologic evidence of recurrenceConsider observation without anti-PD-1 resumption-in this case, durable response was maintained even without resuming anti-PD-1 therapy. Read More

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PJP infection in a patient with high output ileostomy and selective IgA deficiency.

QJM 2019 Jun;112(6):445-446

Respiratory Department, Portiuncula University Hospital, Ballinasloe, Co., Galway H53 T971, Ireland.

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Case report: new development of fibrosing interstitial lung disease triggered by HIV-related pneumocystis pneumonia.

BMC Pulm Med 2019 Mar 18;19(1):65. Epub 2019 Mar 18.

AIDS Clinical Center, National Center of Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.

Background: Fibrosing interstitial lung disease is the poor prognostic non-infectious lung disease by unknown etiology. Here, we present one case developing interstitial pneumonia with fibrosis after treatment of pneumocystis pneumonia (PCP) in newly diagnosed HIV-1 infected case.

Case Presentation: A previously healthy 63-year old male was referred to our institute because of protracted dyspnea on effort in 2 weeks after pneumocystis pneumonia treatment. Read More

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Pneumocystis Pneumonia Complicated by Extensive Diffuse Pneumatoceles.

Am J Med 2019 05 16;132(5):e562-e563. Epub 2019 Jan 16.

Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.

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Pneumocystis jirovecii-related spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema in a liver transplant recipient: a case report.

BMC Infect Dis 2019 Jan 18;19(1):66. Epub 2019 Jan 18.

Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China.

Background: Pneumocystis pneumonia (PCP) is a common opportunistic infection caused by Pneumocystis jirovecii. Its incidence at 2 years or more after liver transplant (LT) is < 0.1%. Read More

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January 2019

Challenging Alveolar Hemorrhage Complicating Pneumonia After Liver Transplantation: A Case Report.

Transplant Proc 2018 Dec 22;50(10):4046-4049. Epub 2018 Jun 22.

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

Alveolar hemorrhage is a life-threatening clinical syndrome often initially thought to be atypical pneumonia. Association with hematopoietic stem cell transplantation is well studied, but not with solid organ transplantation. We report a case of a 54-year-old woman presented with fever and shortness of breath on the third posttransplant day after deceased donor liver transplantation. Read More

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December 2018

Round opacity as a presentation of pneumocystis jirovecii pneumonia in an HIV-infected patient.

Am J Emerg Med 2019 01 30;37(1):176.e3-176.e4. Epub 2018 Sep 30.

Department of Internal Medicine, "Dr. José E. González" University Hospital of the School of Medicine of the Nuevo León Autonomous University, Monterrey, Mexico.

We present the case of a human immunodeficiency virus (HIV)-infected patient who arrived at our emergency department with fever, headache and exertional dyspnea. Throughout their stay, a chest x-ray was taken and a rounded opacity in his left lung was observed. CT images showed same abnormality and also ground glass opacities were seen. Read More

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January 2019

Lung ultrasound in the management of pneumocystis pneumonia: A case series.

Int J STD AIDS 2019 02 20;30(2):188-193. Epub 2018 Sep 20.

Division of Infectious Diseases, Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, Università degli Studi di Milano, Milan, Italy.

Despite the decline in HIV mortality and morbidity, Pneumocystis jirovecii pneumonia (PJP) is still frequently seen, particularly in patients with a low CD4+ cell count. We present a case series where we analyzed the possible role of lung ultrasound (LUS) in the management of PJP in a real-life clinical setting. We describe the ultrasound findings from a consecutive series of six HIV patients hospitalized for PJP, all with a favorable outcome, and evaluated with LUS at admission in our ward and then repeated this once during the hospitalization. Read More

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February 2019