Pneumocystis Carnii

7/24/2019 Pneumocystis Carnii

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Pneumocystis

cariniiKatrina KittlesonSteda Lundak

Parasitology 2007


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Introduction

Fungus or Protozoan??

Orphan organism, phylogenic position has notyet been established

Opportunistic Parasite

Severe pathology in immunodeficient hosts

Severely malnourished newborns

One of the initial signs of AIS emergence

!ives in interstitial tissue of lungs

"arely disseminates to spleen, lymph nodes, bonemarrow, eyes


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Fungus vs# Protozoan

Fungus

from nucleic acid andbiochemical analysis

r"$A homologous to

that found in fungistains with some fungalstains

Affinity for %rocott&smethenamine silverstain

Produces chitinhas ultrastructuralcharacteristics similarto some fungi

Protozoan

other structures similarto Toxoplasma andPlasmodium

is sensitive to a varietyof antiprotozoal agents#

It&s membraneproperties resemblethose of amebas

Shows surface

antigenic variationwhich occurs inprotozoa and has notbeen established infungi


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%eographic istribution

'orldwide

(ost children e)posed by the age

of *+ years-ommonly found in the lungs of

healthy individuals, but no disease

occurs

'idespread in mammals


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.osts

.umans

Pneumocystis jiroveci(i) alternate names

Pneumocystis carinii hominis

/lderly, malnourished children, primaryimmunodeficiency disorders, AIS

Patients receiving cytoto)ic or

immunosupressive drugs for

lymphoresticular cancers or transplants

Other mammals0 rabbits, dogs, goats, swine,

cats, chimpanzees, owl mon1eys, horses


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2ransmission

Aerosol droplets

irect contact

-ongenital infection.ousehold pets

Interspecies transmission?

"eactivation of latent infection whenimmunocompromised

Or, new infection?


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!ife -ycle

!ife cycle is not fully 1nown

Ase)ual and se)ual reproduction 3--4

Four general morphological forms in mammals

2rophozoite 3has amoeboid trophozoite form4Precysts

-ysts

Sporozoites 3intracystic bodies4

-yst 3diagnostic form4chitinous membrane and 5 intracystic bodies

Pore in cyst wall used for releasing sporozoites#

-an be spherical or collapsed#


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!ife -ycle


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-linical Presentation

-auses Pneumonitis, Pneumocystis

pneumonia 3P-P4

!ung epithelium becomes des6uamated

alveoli fill with foamy e)udate

containing parasites

Fever, non productive cough, breathing

difficulty on e)ertion, respiratory failure,cyanosis

eath by asphy)ia


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iagnosis

-linical symptoms

Sputum or bronchial lavage

Special staining with toluidine blue,methenamine silver

%ram+'eigert stain for cysts

/!ISA, immunofluorescence assay,$A amplification being developed


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iagnosis


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Pictures

2rophozoites in 7A!

material#

-ysts in 7A! material


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2reatments

2rimethoprim+sulfametho)azole32(P+S(84

Pentamidine isethionate inhalant

2reatments can be to)ic and patientmust be monitored closely

Prophylactic treatment if - count is

low 39:;;4.AA"2 regimen to boost immunesystem function, corticosteroids


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Pneumocystis cariniiInfection0


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(ore information="eferences

Parasitology te)tboo1

iscussion article

Familydoctor#org

Aafp#org

$ational !ibrary of (edicine http0==

www#nlm#nih#gov=

-enter for isease -ontrol and Preventionhttp0==www#cdc#gov
http://www.nlm.nih.gov/http://www.nlm.nih.gov/http://www.cdc.gov/http://www.cdc.gov/http://www.cdc.gov/http://www.nlm.nih.gov/http://www.nlm.nih.gov/http://www.nlm.nih.gov/

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Pneumocystis Carnii