卡氏肺孢子虫肺炎5例

卡氏肺孢子虫肺炎５例安春丽，陈殿学，陈平，田边将信卡氏肺孢子虫肺炎（Ｐｎｅｕｍｏｃｖｓｔｉｓｃａｒｉｎｉｉｐｎｅｕｍｏｎｉａ，ＰＣＰ．）是ＡＩＤＳ患者常见的最严重的机会性感染性疾病，也是肿瘤化疗，器官移植等细胞免疫功能低下宿主容易感染的一种寄生虫病。...     

卡氏肺孢子虫肺炎

本文就卡氏肺孢子虫肺炎的病原体 ,感染途径 ,临床表现 ,诊断治疗及预防等方面作一概述 ,为卡氏肺孢子虫肺炎的预防控制提供参考。     

卡氏肺孢子虫肺炎

本文就卡氏肺孢子虫肺炎的病原体，感染途径，临床表现，诊断治疗及预防等方面作一概述，为卡氏肺孢子虫肺炎的预防控制提供参考。     

卡氏肺孢子虫肺炎防治研究进展

卡氏肺孢子虫肺炎 (ＰＣＰ)是卡氏肺孢子虫 (Ｐｃ)引起的一种致命性肺炎 ,多见于肿瘤化疗患者、器官移植者、自身免疫病以及各类先天性或后天获得性免疫功能不全者。ＰＣＰ是艾滋病最主要的并发症和死因之一 ,未经预防的艾滋病患者约 80 %发生ＰＣＰ ,若不及时治疗病死率达 10 0 %。一、卡氏肺孢子虫肺炎的治疗Ｐｃ原被认为是一种原虫 ,Ｓｔｒｉｎｇｅｒ分析其 16ＳｒＲＮＡ序列 ,证实它是一种不典型真菌 ,位于子囊菌和担子菌之间 ,其细胞膜富含胆固醇而非普遍存在于真菌细胞膜的麦角固醇 ,对两性霉素Ｂ等抗真菌药物耐药[1] 。目前用于治疗…     

卡氏肺孢子虫

卡氏肺孢子虫 (Peumocystiscarinii,P .c.)是一种可引起免疫抑制个体卡氏肺孢子虫肺炎 (PCP)的不典型真菌。近年来的研究进展很快。本文综述了PC的生物学及流行病学方面的研究现状、DNA扩增技术在PC检测和PCP诊断中的应用、PC传染源、感染途径及抗药株的出现等问题。     

卡氏肺孢子虫肺炎的预防和治疗研究进展

随着艾滋病的流行,位居艾滋病机会感染之首的卡氏肺孢子虫肺炎日益受到医学界的关注,对其预防和治疗的研究取得很大进展。本就预防和治疗该病的动物试验和临床应用研究进展作一简要综述。     

卡氏肺孢子虫

卡氏肺孢子虫(Peumocystis carinii,P.c.)是一种可引起免疫抑制个体卡氏肺孢子虫肺炎(PCP)的不典型真菌。近年来的研究进展很快。本综述了PC的生物学及流行病学方面的研究现状、DNA扩增技术在PC检测和PCP诊断中的应用、PC传染源、感染途径及抗药株的出现等问题。     

卡氏肺孢子虫肺炎动物模型的实验研究

本文通过给大鼠高蛋白质食物，皮下注射醋酸考的松及其饮水中加入四环素的方法，建立了卡氏肺孢子虫大鼠模型。与传统方法比较，证明该方法能使动物模型的病死率降低，成活率提高和寿命延长。     

Genotypes of clustered cases of Pneumocystis carinii pneumonia

Reports of outbreaks of Pneumocystis carinii pneumonia (PCP) among human immunodeficiency virus-negative immunocompromised patients have suggested a person-to-person transmission of P. carinii. In this study, 17 bronchoalveolar lavage isolates from patients in 3 PCP outbreaks were genotyped, 2 in renal transplant recipients and 1 outbreak among patients with haematological disorders. Genotypes in the P. carinii sp. f. hominis (P. carinii f.sp. hominis) mt large subunit ribosomal RNA site 85 were detected by 2 methods: direct sequencing and 3 different allele-specific polymerase chain reaction assays. Although limited data on patient contacts were available, the detected P. c. hominis genotypes do not support person-to-person transmission as the predominant transmission route of P. carinii in humans.     

Pneumocystis carinii pneumonia. Review of 53 cases

Between 1976 and 1983, 53 cases of Pneumocystis carinii pneumonia were documented at the Mayo Clinic. Underlying diseases included leukemia in 15 patients, lymphoma in nine, nonhematologic malignancies in five, acquired immune deficiency syndrome in two, an various inflammatory diseases treated by corticosteroids in 16 patients. Cytotoxic drugs with corticosteroids were used in 68 percent of patients, whereas 23 percent received corticosteroids alone. Clinical features consisted of progressive dyspnea (74 percent), cough (55 percent), and fever (62 percent), with normal findings on examination (43 percent), or crackles (53 percent). Arterial oxygen tension and oxygen saturation were 48.6 +/- 12.8 mm Hg and 81.2 +/- 6.5 percent, respectively. Chest roentgenographs exhibited diffuse alveolar and interstitial infiltrates with predominantly perihilar distribution. The diagnostic rates for open lung biopsy and bronchoscopy were 97 percent and 62 percent, respectively. Clinical improvement and survival following appropriate therapy were noted in 22 patients (41.5 percent), whereas the remaining 31 patients died within four weeks of hospitalization. When survivors were compared with nonsurvivors, there was no difference in mean age, leukocyte counts, arterial oxygen tension, or duration of symptoms before treatment. A coexisting pulmonary infection was identified more frequently in nonsurvivors (51.6 percent) than in survivors (22.7 percent, p = 0.01). The mortality from P. carinii pneumonia alone was 47 percent, whereas 76 percent of those with coexisting infection died. Despite antibiotic therapy and potentially effective chemoprophylaxis, P. carinii pneumonia remains a significant and life-threatening complication of diseases or treatments associated with immune suppression.     

Pneumocystis pneumonia

Pneumocystis (carinii) jiroveci pneumonia can occur in immunocompromised individuals, especially hematopoietic stem and solid organ transplant recipients and those receiving immunosuppressive agents, and is the most common opportunistic infection in persons with advanced human immunodeficiency virus (HIV) infection. The Pneumocystis genus was initially mistaken as a trypanosome and later as a protozoan. Genetic analysis identified the organism as a unicellular fungus. Pneumocystis jiroveci is the species responsible for human infections. A slow indolent time course with symptoms of pneumonia progressing over weeks to months is characteristic in HIV-infected patients. Fulminant respiratory failure associated with fever and dry cough is typical in non-HIV-infected patients. Definitive diagnosis relies on histopathological testing of sputum, induced or sampled by fiberoptic bronchoscopy with bronchoalveolar lavage. The first-line drug for treatment and prevention is trimethoprim-sulfamethoxazole.     

Pneumocystis pneumonia

Pneumocystis is an opportunistic fungus that is a major cause of morbidity and mortality in immunocompromised hosts. Despite a decline in incidence with the advent of highly active antiretroviral therapy (HAART), Pneumocystis remains the most common opportunistic infection in patients with the acquired immunodeficiency syndrome (AIDS) and is an increasing cause of disease in patients with other forms of immunosuppression. Although there have been advances in the prevention and treatment of this infection, the mortality for Pneumocystis pneumonia (PCP) in the setting of AIDS remains 10 to 20%. The mortality for patients with other forms of immunosuppression is poorly defined but may actually be higher than that reported in the setting of AIDS. The continued severity of PCP in the AIDS population, its increasing frequency in other immunosuppressed populations, and increasing evidence that normal hosts may serve as a reservoir for the organism merit continued evaluation of the epidemiology, clinical presentation, diagnosis, and treatment of this infection.     

8例AIDS相关难治性耶氏肺孢子菌肺炎原因分析及文献复习

[摘要]?耶氏肺孢子菌肺炎（Pneumocystis jirovecii pneumonia, PCP）是AIDS患者最常见且严重的机会性感染之一,因耶氏肺孢子菌自身的病原学特点,PCP的诊断和治疗均存在一定程度的困难。本文对我院收治的8例首诊为“AIDS相关PCP”的病例在诊断、治疗过程中的困难和原因以及治疗结局进行报道并复习文献。     

Pneumocystis carinii pneumonia

Pneumocystis carinii pneumonia (PCP) is the most common index diagnosis in patients with acquired immunodeficiency syndrome (AIDS). Eighty percent of AIDS patients will eventually develop PCP. Common presenting symptoms are shortness of breath, cough, weight loss, and fever. The chest radiograph typically reveals a diffuse, bilateral, symmetric, fine-to-medium reticulonodular pattern of opacities. Upper lobe disease has been reported recently in patients who have undergone prophylactic therapy with aerosolized pentamidine. Pneumatoceles, or thin-walled air-containing cysts, have been noted in 10% of patients with PCP. Lymphadenopathy and pleural effusion are extremely rare. Therapy with various agents is generally successful, resulting in clinical and radiographic improvement within 7 to 10 days. Recurrence of PCP is common.