• Pediatric Infection and Vaccine
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• v.4 no.1
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• pp.174-182
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• 1997

Pneumocystis carinii pneumonia mainly occurs in immunocompromised patients and it is also known of major cause of death in children with acute lymphoblastic leukemia. After consolidation chemotherapy, acute lymphoblastic leukemia children is developed Pneumocystis carinii pneumonia frequently no an opportunistic infection but there were no controlled studies which have been performed to evaluate the usefulness of corticosteroid in Pneumocystis carinii pneumonia with acute lymphoblastic leukemia. We experienced a case of Pneumocystis carinii pneumonia in acute lymphoblastic leukemia with febrile neutropenic 6 years old girl. She was treated with trimethoprim-sulfamethoxazole and prednisone. We report this case with brief review of related literature.

• Tuberculosis and Respiratory Diseases
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• v.83 no.2
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• pp.132-140
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• 2020

In human immunodeficiency virus (HIV)-infected patients, Pneumocystis jirovecii pneumonia (PCP) is a well-known opportunistic infection and its management has been established. However, PCP is an emerging threat to immunocompromised patients without HIV infection, such as those receiving novel immunosuppressive therapeutics for malignancy, organ transplantation, or connective tissue diseases. Clinical manifestations of PCP are quite different between patients with and without HIV infections. In patients without HIV infection, PCP rapidly progresses, is difficult to diagnose correctly, and causes severe respiratory failure with a poor prognosis. High-resolution computed tomography findings are different between PCP patients with HIV infection and those without. These differences in clinical and radiological features are due to severe or dysregulated inflammatory responses that are evoked by a relatively small number of Pneumocystis organisms in patients without HIV infection. In recent years, the usefulness of polymerase chain reaction and serum β-D-glucan assay for rapid and non-invasive diagnosis of PCP has been revealed. Although corticosteroid adjunctive to anti-Pneumocystis agents has been shown to be beneficial in some populations, the optimal dose and duration remain to be determined. Recent investigations revealed that Pneumocystis colonization is prevalent and that asymptomatic carriers are at risk for developing PCP and can serve as the reservoir for the spread of Pneumocystis by airborne transmission. These findings suggest the need for chemoprophylaxis in immunocompromised patients as well as infection control measures, although the indications remain controversial. Because a variety of novel immunosuppressive therapeutics have been emerging in medical practice, further innovations in the diagnosis and treatment of PCP are needed.

• Korean Journal of Veterinary Research
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• v.47 no.3
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• pp.321-324
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• 2007

Pneumocystis (P.) carinii is an opportunistic fungal pathogen of many animal species and human, which can cause fatal pneumonia in immunocompromised individuals. Three 100-day-old pigs with progressive atrophy, anorexia and respiratory distress were submitted to the Cheju National University for diagnosis. Grossly, the lungs were enlarged with rubbery consistency. Histopathologically, the lungs were characterized by diffuse interstitial pneumonia with thickening of alveolar septa due to infiltration of macrophages and lymphocytes. Alveolar lumens were filled with a foamy eosinophilic proteinaceous material in which numerous punctiform organisms. The organisms were demonstrated as P. carinii by Grocott-methenamine-silver staining and immunohistochemistry in lungs of two pigs. In our best knowledge, this is believed to be the first report of P. carinii pneumonia in pigs in Korea.

• Pediatric Infection and Vaccine
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• v.12 no.1
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• pp.95-99
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• 2005

Pneumocystis carinii pneumonia is an infectious disease which is highly prevalent in the group of immunosuppressed patients, particularly with hematologic tumors as lymphomas and acquired immune deficiency syndrome(AIDS), severe malnutrition, organ transplantations, high dose corticosteroid therapy. Some cases of Pneumocystis carinii pneumonia in infants with primary immune deficiency were already reported. The authors present a case of Pneumocystis carinii pneumonia developed in an infant who suffered from 10 days of poor feeding and failure to thrive and not included in the risk groups listed above. He had bilateral interstitial infiltrations on the chest radiography, diagnosed as Pneumocystis carinii pneumonia after Gomori-methenamine silver staining of his sputum that was taken through tracheal intubation. He improved after administering Trimethoprim-sulfamethoxazole for 14 days.

• Parasites, Hosts and Diseases
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• v.37 no.4
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• pp.271-275
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• 1999

Pneumocystis carinii is the most important opportunistic pathogen of humans in the world. Pneumocystis carinii is experimentally detected in the lungs of rats, mice, rabbits, and monkeys, however, the organisms from different mammals are identical in microscopic morphology. The present study tried to find out more mammalian hosts of P. carinii and also to differentiate the organisms from different mammals by karyotyping. Rats, mice, hamsters, rabbits, cats, and dogs were successfully infected by P. carinii, but guinea pigs and pigs were not. Karyotype of P. carinii from rabbits showed similar size range of chromosomes with that of the prototype, but in different pattern. The patterns from cats and dogs were also different from that of rats. The present study confirms that cats and dogs are infected by P. carinii and at least total three karyotype strains of P. carinii are proven in Korea.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.1-9
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• 1994

The cytological and ultrastructural findings of Pneumocystis carinii(PC) obtained from rats by bronchoalveolar lavage (BAL) are described. All developmental forms of the PC organisms were obtained in the lavage fluid. Papanicolaou stain revealed conglomeration of PC as a foamy cast. The cystic walls of PC were well identified on Gomori's methenamine silver stain. Trophozoites and intracystic bodies were stained by Giemsa and Diff-Quik techniques. Some PC organisms were seen within the alveolar macrophages. Ultrastructurally, the cysts were almost circular in shape, and were nearly devoid of surface tubular extensions. The wall of the cyst was composed of an unit membrane, an intermediate electron lucent layer and an external electron dense layer The cysts frequently contained intracystic bodies, so called sporozoites. Occasionally empty or collapsed cysts with no intracystic bodies, and precysts were found. Trophozoites were variable in size and shape with abundant tubular extensions along the single electron dense pellicle. BAL is a useful method for concentrating the various morphologic forms of PC organisms, and is a rapid diagnostic method for PC pneumonia.

• Parasites, Hosts and Diseases
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• v.29 no.4
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• pp.355-362
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• 1991

A total of 2,580 sera of the patients who were consulted to the serology laboratory of the Seoul National University Hospital were collected in 1990. The sera were screened by micro-ELISA to detect IgG antibody reacting with Pneumocystis carinii antigen. The absorbances were 0.00 to 1.41 and mean 0.27±0.253. As the positive criterion was set absorbance 0.2 or more with 70% sensitivity, total positive rate was 44.4oA. Mean absorbances and positive rates were higher in children than in adults; 0.40 and 62.9% in 0 year group, 0.50 and 81.2% in 1 year group, 0.41 and 66.0% in 2-3 year group, 0.33 and 61.4% in 4-5 year group, 0.25 and 42.3% in 6-10 year group respectively. In the age groups over 11 years, the absorbances were in range of 0.16 to 0.23 and the positive rates were 26.1% to 41.5%. The present level of absorbances and positive rates could be regarded similar with those in normal Korean population. The present findings suggest that most humans are exposed to Pneumocystis within 2 years after birth and meet much less new antigenic challenge after 11 years in Korea.

• Clinical and Experimental Pediatrics
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• v.59 no.6
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• pp.252-255
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• 2016

Purpose: Pneumocystis jirovecii pneumonia occurs in various immunocompromised patients. Despite the prophylaxis strategies in clinical practice, certain patients develop P. jirovecii pneumonia. This study was performed to investigate pediatric cases with P. jirovecii pneumonia in a single center. Methods: We identified pediatric patients younger than 19 years with microbiologically confirmed P. jirovecii pneumonia from January 2000 to February 2014. A retrospective chart review was performed. Results: Fifteen episodes of P. jirovecii pneumonia in 14 patients were identified with median age of 8.3 years (range, 0.4-18.6 years). Among these patients, 11 patients had hematology-oncology diseases, 2 had primary immunodeficiency disorders (one with severe combined immunodeficiency and the other with Wiskott Aldrich syndrome), 1 had systemic lupus erythematosus and 1 received kidney transplant. Four patients were transplant recipients; 1 allogeneic and 2 autologous hematopoietic cell transplant and 1 with kidney transplant. The median absolute lymphocyte count at the diagnosis of P. jirovecii pneumonia was $5,156cells/mm^3$ (range, $20-5,111cells/mm^3$). In 13 episodes (13 of 15, 86.7%), patients were not receiving prophylaxis at the onset of P. jirovecii pneumonia. For treatment, trimethoprim/sulfamethoxazole was given as a main therapeutic agent in all 15 episodes. Steroid was given in 9 episodes (60%). Median treatment duration was 15 days (range, 4-33 days). Overall mortality at 60 days was 35.7% (5 of 14). Conclusion: Majority of our patients developed P. jirovecii pneumonia while not on prophylaxis. Continuous efforts and more data are needed to identify high risk patients who may get benefit from P. jirovecii pneumonia prophylaxis.

• Tuberculosis and Respiratory Diseases
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• v.71 no.5
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• pp.322-327
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• 2011

Background: Pneumocystis jirovecii is a fungus that has become an important cause of opportunistic infections. We present a summary of the clinical status and findings from bronchoalveolar lavage (BAL) of patients with Pneumocystis jirovecii pneumonia (PJP). Methods: We selected 30 cases of PJP that were proven through a surgical specimen evaluation. BAL fluid cytology was reviewed, and agreement with the initial diagnosis was evaluated. Results: All 30 cases of PJP occurred in immunocompromised patients. Only 15 of the 30 cases were initially diagnosed as PJP. We found PJP in 13 of the 15 cases that were negative at the initial diagnosis. The most characteristic finding of PJP was frothy exudates, and BAL fluid tended to show rare neutrophils. Two of seven patients with PJP and diffuse alveolar damage (DAD) revealed no frothy exudates in BAL fluid. Conclusion: BAL fluid cytology was reconfirmed as a sensitive and rapid method to diagnose PJP. We must be aware of the possibility of PJP to maintain high diagnostic sensitivity. We cannot exclude PJP in cases of PJP with DAD, even if frothy exudates are not observed in the BAL fluid.

• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.394-399
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• 1995

Pneumocystis carinii pneumonia(PCP) remains the leading cause of death in patients with AIDS. Although the most common radiographic presentation of PCP is the development of diffuse, bilateral interstitial or alveolar infiltrates in 48 to 86 per cent of AIDS patients, PCP may also present with either a completely normal or only minimally abnormal chest radiograph in 6 to 23 per cent of patients. We experienced two patients with AIDS presenting high fever and chest pain but normal chest radiograph, who had been proved to have PCP by bronchoalveolar lavage and trans-bronchial lung biopsy.