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Pneumocystis jirovecii and Pneumocystosis

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Current Progress in Medical Mycology

Abstract

Pneumocystis jirovecii pneumonia (PcP or pneumocystosis) remains a major cause of respiratory illness among immunocompromised patients, especially those infected with the human immunodeficiency virus (HIV). P. jirovecii infection has also been detected in healthy individuals and people with chronic lung diseases, raising the possibility that the spectrum of illness caused by this pathogenic fungus may extend well beyond the immunocompromised host. In industrialized countries, while the number of acquired immunodeficiency syndrome (AIDS) patients suffering from PcP decreases, there is a rising number of non-HIV immunocompromised patients at risk for life-threatening PcP. In contrast, in developing countries a limited number of epidemiological studies have evaluated PcP prevalence; however, recent reports have described an increased rate of the disease in AIDS patients in Africa, Asia and South America.

After nearly three decades of intensive research, a significant progress has been made in the understanding of PcP; however, this disease continues to be a challenge for clinicians and microbiologists; in particular, the processes of detection and interpretation of the PcP testing, because even the most current diagnostic methods cannot adequately differentiate between colonized (asymptomatic) and symptomatic patients.

This chapter reviews the basic biology of P. jirovecii and the epidemiology of the caused infection, including genetic diversity. It also discusses pathogenesis and host defences against P. jirovecii, and the clinical presentation in HIV-infected and non-HIV-infected immunocompromised patients. Attention will be devoted to classic and modern approaches for diagnosis, as well as to treatment and prophylaxis of PcP. This chapter is designed to present a balanced, comprehensive, and concise examination of the latest advances in the field of P. jirovecii pneumonia, and to contain the most up-to-date references.

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Authors and Affiliations

  1. Medical Parasitology Unit, Group of Opportunistic Protozoa/HIV and Other Protozoa, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisboa, Portugal

    Olga Matos M.D., M.Sc., Ph.D. & Ana Luisa Tomás M.Sc., Ph.D. student

  2. Instituto de Saúde Ambiental, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal

    Francisco Antunes M.D., Ph.D.

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  1. Olga Matos M.D., M.Sc., Ph.D.
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  2. Ana Luisa Tomás M.Sc., Ph.D. student
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  3. Francisco Antunes M.D., Ph.D.
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Correspondence to Olga Matos M.D., M.Sc., Ph.D. .

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  1. Universidad de Guanajuato, Guanajuato, Mexico

    Héctor M. Mora-Montes

  2. Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil

    Leila M. Lopes-Bezerra

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Matos, O., Tomás, A.L., Antunes, F. (2017). Pneumocystis jirovecii and Pneumocystosis. In: Mora-Montes, H., Lopes-Bezerra, L. (eds) Current Progress in Medical Mycology. Springer, Cham. https://doi.org/10.1007/978-3-319-64113-3_7

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