Pneumocystis jirovecii Pneumonia in Children with Hematological Malignancies: Diagnosis and Approaches to Management
Abstract
:1. Introduction
2. P. jirovecii in Human Disease
3. Clinical Picture and Imaging Findings of PJP
4. Laboratory Diagnosis of PJP
5. Differential Diagnosis of PJP
6. Prophylaxis against PJP
7. Treatment of PJP
8. Conclusions
Funding
Acknowledgments
Conflicts of Interest
References
- Chagas, C. Uber eine neue Trypoanosomiasis des Menschen. Mem. Inst. Oswaldo Cruz 1909, 3, 1–218. [Google Scholar]
- Vanek, J.; Jirovec, O. Parasitic pneumonia. Interstitial plasma cell pneumonia of premature, caused by pneumocystis Carinii. Zent. Bakteriol. Parasit. Infekt. Hygiene 1952, 158, 120–127. [Google Scholar]
- Stringer, J.R.; Beard, C.B.; Miller, R.F.; Wakefield, A.E. A New Name forPneumocystisfrom Humans and New Perspectives on the Host-Pathogen Relationship. Emerg. Infect. Dis. 2002, 8, 891–896. [Google Scholar] [CrossRef]
- Edman, J.C.; Kovacs, J.A.; Masur, H.; Santi, D.V.; Elwood, H.J.; Sogin, M.L. Ribosomal RNA sequence shows Pneumocystis carinii to be a member of the Fungi. Nat. Cell Biol. 1988, 334, 519–522. [Google Scholar] [CrossRef]
- Schildgen, V.; Mai, S.; Khalfaoui, S.; Lüsebrink, J.; Pieper, M.; Tillmann, R.L.; Brockmann, M.; Schildgen, O. Pneumocystis jirovecii Can Be Productively Cultured in Differentiated CuFi-8 Airway Cells. mBio 2014, 5, e01079-14. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Song, Y.; Ren, Y.; Wang, X.; Li, R. Recent Advances in the Diagnosis of Pneumocystis Pneumonia. Med. Mycol. J. 2016, 57, E111–E116. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gajdusek, D.C. Pneumocystis carinii as the cause of human disease: Historical perspective and magnitude of the problem: Introductory remarks. Natl. Cancer Inst. Monogr. 1976, 43, 1–11. [Google Scholar] [PubMed]
- Hallett, J.J.; Fickenscher, L.G.; Ablin, A.R. Pneumocystis Carinii Pneumonia in Children. West. J. Med. 1977, 126, 441–444. [Google Scholar]
- Mansell, P.W.A. Acquired Immune Deficiency Syndrome, Leading to Opportunistic Infections, Kaposi’s Sarcoma, and Other Malignancies. CRC Crit. Rev. Clin. Lab. Sci. 1984, 20, 191–204. [Google Scholar] [CrossRef]
- Saltzman, R.W.; Albin, S.; Russo, P.; Sullivan, K.E. Clinical conditions associated with PCP in children. Pediatr. Pulmonol. 2011, 47, 510–516. [Google Scholar] [CrossRef]
- Russian, D.A.; Levine, S.J. Pneumocystis carinii Pneumonia in Patients without HIV Infection. Am. J. Med. Sci. 2001, 321, 56–65. [Google Scholar] [CrossRef]
- Sepkowitz, K.A. Pneumocystis carinii pneumonia without acquired immunodeficiency syndrome. More patients, same risk. Arch. Intern. Med. 1995, 155, 1125–1128. [Google Scholar] [CrossRef]
- Pagano, L.; Caira, M.; Fianchi, L. Pulmonary fungal infection with yeasts andpneumocystisin patients with hematological malignancy. Ann. Med. 2005, 37, 259–269. [Google Scholar] [CrossRef]
- Aoki, Y.; Iwamoto, M.; Kamata, Y.; Nagashima, T.; Yoshio, T.; Okazaki, H.; Minota, S. Prognostic indicators related to death in patients with Pneumocystis pneumonia associated with collagen vascular diseases. Rheumatol. Int. 2009, 29, 1327–1330. [Google Scholar] [CrossRef]
- Martin, S.I.; Fishman, J.A.; the AST Infectious Diseases Community of Practice. Pneumocystis Pneumonia in Solid Organ Transplantation. Arab. Archaeol. Epigr. 2013, 13, 272–279. [Google Scholar] [CrossRef]
- Bienvenu, A.-L.; Traore, K.; Plekhanova, I.; Bouchrik, M.; Bossard, C.; Picot, S. Pneumocystis pneumonia suspected cases in 604 non-HIV and HIV patients. Int. J. Infect. Dis. 2016, 46, 11–17. [Google Scholar] [CrossRef] [Green Version]
- Maini, R.; Henderson, K.L.; Sheridan, E.A.; Lamagni, T.; Nichols, G.; Delpech, V.; Phin, N. Increasing Pneumocystis Pneumonia, England, UK, 2000–2010. Emerg. Infect. Dis. 2013, 19, 386–392. [Google Scholar] [CrossRef] [Green Version]
- Hughes, W.T.; Price, R.A.; Kim, H.-K.; Coburn, T.P.; Grigsby, D.; Feldman, S. Pneumocystis carinii pneumonitis in children with malignancies. J. Pediatr. 1973, 82, 404–415. [Google Scholar] [CrossRef]
- Schmiegelow, K.; Attarbaschi, A.; Barzilai, S.; Escherich, G.; Frandsen, T.L.; Halsey, C.; Hough, R.; Jeha, S.; Kato, M.; Liang, D.-C.; et al. Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: A Delphi consensus. Lancet Oncol. 2016, 17, e231–e239. [Google Scholar] [CrossRef]
- Mahindra, A.K.; Grossman, S.A. Pneumocystis carinii pneumonia in HIV negative patients with primary brain tumors. J. Neuro-Oncol. 2003, 63, 263–270. [Google Scholar] [CrossRef]
- Sepkowitz, K.A.; Brown, A.E.; Telzak, E.E.; Gottlieb, S.; Armstrong, D. Pneumocystis carinii pneumonia among patients without AIDS at a cancer hospital. JAMA 1992, 267, 832–837. [Google Scholar] [CrossRef]
- Yale, S.H.; Limper, A.H. Pneumocystis carinii Pneumonia in Patients Without Acquired Immunodeficiency Syndrome: Associated Illnesses and Prior Corticosteroid Therapy. Mayo Clin. Proc. 1996, 71, 5–13. [Google Scholar] [CrossRef] [PubMed]
- Hashimoto, A.; Suto, S.; Horie, K.; Fukuda, H.; Nogi, S.; Iwata, K.; Tsuno, H.; Ogihara, H.; Kawakami, M.; Komiya, A.; et al. Incidence and Risk Factors for Infections Requiring Hospitalization, Including Pneumocystis Pneumonia, in Japanese Patients with Rheumatoid Arthritis. Int. J. Rheumatol. 2017, 2017, 1–8. [Google Scholar] [CrossRef]
- Basiaga, M.L.; Ross, M.E.; Gerber, J.S.; Ogdie, A. Incidence of Pneumocystis jirovecii and Adverse Events Associated with Pneumocystis Prophylaxis in Children Receiving Glucocorticoids. J. Pediatr. Infect. Dis. Soc. 2018, 7, 283–289. [Google Scholar] [CrossRef]
- Caselli, D.; Petris, M.G.; Rondelli, R.; Carraro, F.; Colombini, A.; Muggeo, P.; Ziino, O.; Melchionda, F.; Russo, G.; Pierani, P.; et al. Single-Day Trimethoprim/Sulfamethoxazole Prophylaxis for Pneumocystis Pneumonia in Children with Cancer. J. Pediatr. 2014, 164, 389–392. [Google Scholar] [CrossRef]
- Naz, N.; Chiu, Y.; Edwards, M.; Redfern, A. 333. Evaluating the Risk of Pneumocystis Jirovecii Pneumonia (PCP) in Renal and Non-Remal Vasculitis Patints. Rheumatology 2019, 58, 2004–2009. [Google Scholar] [CrossRef] [Green Version]
- Poulsen, A.; Demeny, A.K.; Plum, C.B.; Nielsen, K.G.; Schmiegelow, K. Pneumocystis carinii pneumonia during maintenance treatment of childhood acute lymphoblastic leukemia. Med. Pediatr. Oncol. 2001, 37, 20–23. [Google Scholar] [CrossRef]
- Jayshree, R.S.; Appaji, L.; Sridhar, H. Pneumocystis carinii pneumonia in two patients with Hodgkin’s disease. Indian J. Cancer 1995, 32, 74–76. [Google Scholar]
- Williams, K.M.; Ahn, K.W.; Chen, M.; Aljurf, M.D.; Agwu, A.L.; Chen, A.R.; Walsh, T.J.; Szabolcs, P.; Boeckh, M.J.; Auletta, J.J.; et al. The incidence, mortality and timing of Pneumocystis jiroveci pneumonia after hematopoietic cell transplantation: A CIBMTR analysis. Bone Marrow Transplant. 2016, 51, 573–580. [Google Scholar] [CrossRef] [Green Version]
- Pifer, L.L.; Hughes, W.T.; Stagno, S.; Woods, D. Pneumocystis carinii infection: Evidence for high prevalence in normal and immunosuppressed children. Pediatrics 1978, 61, 35–41. [Google Scholar]
- Vargas, S.L.; Hughes, W.T.; Santolaya, M.E.; Ulloa, A.V.; Ponce, C.A.; Cabrera, C.E.; Cumsille, F.; Gigliotti, F. Search for Primary Infection by Pneumocystis carinii in a Cohort of Normal, Healthy Infants. Clin. Infect. Dis. 2001, 32, 855–861. [Google Scholar] [CrossRef] [Green Version]
- White, P.L.; Backx, M.; Barnes, R.A. Diagnosis and management of Pneumocystis jirovecii infection. Expert Rev. Anti-Infect. Ther. 2017, 15, 435–447. [Google Scholar] [CrossRef]
- Walzer, P.D. Attachment of microbes to host cells: Relevance of Pneumocystis carinii. Lab. Investig. 1986, 54, 589–592. [Google Scholar] [PubMed]
- Gianella, S.; Haeberli, L.; Joos, B.; Ledergerber, B.; Wüthrich, R.; Weber, R.; Kuster, H.; Hauser, P.; Fehr, T.; Mueller, N. Molecular evidence of interhuman transmission in an outbreak ofPneumocystis jiroveciipneumonia among renal transplant recipients. Transpl. Infect. Dis. 2010, 12, 1–10. [Google Scholar] [CrossRef]
- Morris, A.; Beard, C.; Huang, L. Update on the epidemiology and transmission of Pneumocystis carinii. Microbes Infect. 2002, 4, 95–103. [Google Scholar] [CrossRef]
- Nevez, G.; Chabe, M.; Rabodonirina, M.; Virmaux, M.; Dei-Cas, E.; Hauser, P.M.; Totet, A. Nosocomial Pneumocystis jirovecii infections. Parasite 2008, 15, 359–365. [Google Scholar] [CrossRef] [Green Version]
- Kovacs, J.A.; Gill, V.J.; Meshnick, S.; Masur, H. New Insights into Transmission, Diagnosis, and Drug Treatment of Pneumocystis carinii Pneumonia. JAMA 2001, 286, 2450–2460. [Google Scholar] [CrossRef]
- Fréalle, E.; Valade, S.; Guigue, N.; Hamane, S.; Chabé, M.; Le Gal, S.; Damiani, C.; Totet, A.; Aliouat, E.M.; Nevez, G.; et al. Diffusion of Pneumocystis jirovecii in the surrounding air of patients with Pneumocystis colonization: Frequency and putative risk factors: Table 1. Med. Mycol. 2016, 55, 568–572. [Google Scholar] [CrossRef] [Green Version]
- Luna, M.A.; Cleary, K.R. Spectrum of pathologic manifestations of Pneumocystis carinii pneumonia in patients with neoplastic diseases. Semin. Diagn. Pathol. 1989, 6, 262–272. [Google Scholar]
- Wright, T.W.; Gigliotti, F.; Finkelstein, J.N.; McBride, J.T.; An, C.L.; Harmsen, A.G. Immune-mediated inflammation directly impairs pulmonary function, contributing to the pathogenesis of Pneumocystis carinii pneumonia. J. Clin. Investig. 1999, 104, 1307–1317. [Google Scholar] [CrossRef]
- Bollée, G.; Sarfati, C.; Thiéry, G.; Bergeron, A.; de Miranda, S.; Menotti, J.; de Castro, N.; Tazi, A.; Schlemmer, B.; Azoulay, E. Clinical Picture of Pneumocystis jiroveci Pneumonia in Cancer Patients. Chest 2007, 132, 1305–1310. [Google Scholar] [CrossRef]
- Salzer, H.J.; Schäfer, G.; Hoenigl, M.; Günther, G.; Hoffmann, C.; Kalsdorf, B.; Alanio, A.; Lange, C. Clinical, Diagnostic, and Treatment Disparities between HIV-Infected and Non-HIV-Infected Immunocompromised Patients with Pneumocystis jirovecii Pneumonia. Respiration 2018, 96, 52–65. [Google Scholar] [CrossRef]
- Kovacs, J.A.; Hiemenz, J.W.; Macher, A.M.; Stover, D.; Murray, H.W.; Shelhamer, J.; Lane, H.C.; Urmacher, C.; Honig, C.; Longo, D.L. Pneumocystis carinii pneumonia: A comparison between patients with the acquired immunodeficiency syndrome and patients with other immunodeficiencies. Ann. Intern. Med. 1984, 100, 663–671. [Google Scholar] [CrossRef]
- Fillatre, P.; Decaux, O.; Jouneau, S.; Revest, M.; Gacouin, A.; Robert-Gangneux, F.; Fresnel, A.; Guiguen, C.; Le Tulzo, Y.; Jégo, P.; et al. Incidence of Pneumocystis jiroveci Pneumonia among Groups at Risk in HIV-negative Patients. Am. J. Med. 2014, 127, 1242.e11–1242.e17. [Google Scholar] [CrossRef] [Green Version]
- Liu, Y.; Su, L.; Jiang, S.-J.; Qu, H. Risk factors for mortality from pneumocystis carinii pneumonia (PCP) in non-HIV patients: A meta-analysis. Oncotarget 2017, 8, 59729–59739. [Google Scholar] [CrossRef] [Green Version]
- Kanne, J.P.; Yandow, D.R.; Meyer, C.A. Pneumocystis jiroveci Pneumonia: High-Resolution CT Findings in Patients with and Without HIV Infection. Am. J. Roentgenol. 2012, 198, W555–W561. [Google Scholar] [CrossRef] [Green Version]
- Toma, P.; Bertaina, A.; Castagnola, E.; Colafati, G.S.; D’Andrea, M.L.; Finocchi, A.; Lucidi, V.; Mastronuzzi, A.; Granata, C. Fungal infections of the lung in children. Pediatr. Radiol. 2016, 46, 1856–1865. [Google Scholar] [CrossRef]
- Vogel, M.N.; Vatlach, M.; Weissgerber, P.; Goeppert, B.; Claussen, C.; Hetzel, J.; Horger, M.S. HRCT-features of Pneumocystis jiroveci pneumonia and their evolution before and after treatment in non-HIV immunocompromised patients. Eur. J. Radiol. 2012, 81, 1315–1320. [Google Scholar] [CrossRef]
- Kunihiro, Y.; Tanaka, N.; Kawano, R.; Yujiri, T.; Kubo, M.; Ueda, K.; Gondo, T.; Kobayashi, T.; Matsumoto, T. Differential diagnosis of pulmonary infections in immunocompromised patients using high-resolution computed tomography. Eur. Radiol. 2019, 29, 6089–6099. [Google Scholar] [CrossRef]
- Hardak, E.; Brook, O.; Yigla, M. Radiological Features of Pneumocystis jirovecii Pneumonia in Immunocompromised Patients with and Without AIDS. Lung 2010, 188, 159–163. [Google Scholar] [CrossRef]
- Chou, C.-W.; Chao, H.-S.; Lin, F.-C.; Tsai, H.-C.; Yuan, W.-H.; Chang, S.-C. Clinical Usefulness of HRCT in Assessing the Severity of Pneumocystis jirovecii Pneumonia. Medicine 2015, 94, e768. [Google Scholar] [CrossRef]
- Hopewell, P.C. Diagnosis of Pneumocystis carinii pneumonia. Infect. Dis. Clin. N. Am. 1988, 2, 409–418. [Google Scholar] [CrossRef]
- Kono, M.; Yamashita, H.; Kubota, K.; Kano, T.; Mimori, A. FDG PET Imaging in Pneumocystis Pneumonia. Clin. Nucl. Med. 2015, 40, 679–681. [Google Scholar] [CrossRef]
- Nakazato, T.; Mihara, A.; Sanada, Y.; Suzuki, K.; Aisa, Y.; Iwabuchi, M.; Kakimoto, T. Pneumocystis jiroveci pneumonia detected by FDG-PET. Ann. Hematol. 2010, 89, 839–840. [Google Scholar] [CrossRef]
- Win, Z.; Todd, J.; Al-Nahhas, A. FDG-PET Imaging in Pneumocystis carinii Pneumonia. Clin. Nucl. Med. 2005, 30, 690–691. [Google Scholar] [CrossRef]
- Cordonnier, C.; Cesaro, S.; Maschmeyer, G.; Einsele, H.; Donnelly, J.P.; Alanio, A.; Hauser, P.M.; Lagrou, K.; Melchers, W.J.G.; Helweg-Larsen, J.; et al. Pneumocystis jirovecii pneumonia: Still a concern in patients with haematological malignancies and stem cell transplant recipients. J. Antimicrob. Chemother. 2016, 71, 2379–2385. [Google Scholar] [CrossRef] [Green Version]
- Schmidt, J.J.; Lueck, C.; Ziesing, S.; Stoll, M.; Haller, H.; Gottlieb, J.; Eder, M.; Welte, T.; Hoeper, M.M.; Scherag, A.; et al. Clinical course, treatment and outcome of Pneumocystis pneumonia in immunocompromised adults: A retrospective analysis over 17 years. Crit. Care 2018, 22, 307. [Google Scholar] [CrossRef] [Green Version]
- Aderaye, G.; Woldeamanuel, Y.; Asrat, D.; Lebbad, M.; Beser, J.; Worku, A.; Fernandez, V.; Lindquist, L. Evaluation of Toluidine Blue O Staining for the Diagnosis of Pneumocystis jiroveci in Expectorated Sputum Sample and Bronchoalveolar Lavage from HIV-infected Patients in a Tertiary Care Referral Center in Ethiopia. Infection 2008, 36, 237–243. [Google Scholar] [CrossRef]
- Cregan, P.; Yamamoto, A.; Lum, A.; Vanderheide, T.; Macdonald, M.; Pulliam, L. Comparison of four methods for rapid detection of Pneumocystis carinii in respiratory specimens. J. Clin. Microbiol. 1990, 28, 2432–2436. [Google Scholar] [CrossRef] [Green Version]
- Walker, J.; Conner, G.; Ho, J.; Hunt, C.; Pickering, L. Giemsa staining for cysts and trophozoites of Pneumocystis carinii. J. Clin. Pathol. 1989, 42, 432–434. [Google Scholar] [CrossRef]
- Gonzalez, A.A.; Hamele-Bena, D.; Wood, T.; Valladares-Silva, S.; Wasserman, P.G. Pneumocystis jirovecii immunostain versus Gomori/Grocott methenamine silver stain of bronchoalveolar lavage in cell blocks: An institutional experience. J. Am. Soc. Cytopathol. 2017, 6, 242–247. [Google Scholar] [CrossRef]
- Homayouni, M.M.; Rostami, A.; Gholizadeh, H.; Mehbod, A.S.A.; Ebrahimi, M.; Mehravar, S. Comparison of three cost effective staining methods for detection of Pneumocystis jirovecii. J. Parasit. Dis. 2016, 41, 298–301. [Google Scholar] [CrossRef] [Green Version]
- Alanio, A.; Bretagne, S. Pneumocystis jirovecii detection in asymptomatic patients: What does it natural history tell us? F1000Research 2017, 6, 739. [Google Scholar] [CrossRef] [Green Version]
- Maschmeyer, G.; Carratalà, J.; Buchheidt, D.; Hamprecht, A.; Heussel, C.; Kahl, C.; Lorenz, J.; Neumann, S.; Rieger, C.; Ruhnke, M.; et al. Diagnosis and antimicrobial therapy of lung infiltrates in febrile neutropenic patients (allogeneic SCT excluded): Updated guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann. Oncol. 2015, 26, 21–33. [Google Scholar] [CrossRef]
- de Leeuw, B.H.; Voskuil, W.S.; Maraha, B.; van der Zee, A.; Westenend, P.J.; Kusters, J.G. Evaluation of different real time PCRs for the detection of Pneumocystis jirovecii DNA in formalin-fixed paraffin-embedded bronchoalveolar lavage samples. Exp. Mol. Pathol. 2015, 98, 390–392. [Google Scholar] [CrossRef]
- Alanio, A.; Hauser, P.M.; Lagrou, K.; Melchers, W.J.G.; Helweg-Larsen, J.; Matos, O.; Cesaro, S.; Maschmeyer, G.; Einsele, H.; Donnelly, J.P.; et al. ECIL guidelines for the diagnosis of Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell transplant recipients. J. Antimicrob. Chemother. 2016, 71, 2386–2396. [Google Scholar] [CrossRef]
- Döşkaya, M.; Caner, A.; Değirmenci, A.; Wengenack, N.L.; Yolasığmaz, A.; Turgay, N.; Töz, S.Ö.; Gürüz, Y. Degree and frequency of inhibition in a routine real-time PCR detecting Pneumocystis jirovecii for the diagnosis of Pneumocystis pneumonia in Turkey. J. Med. Microbiol. 2011, 60, 937–944. [Google Scholar] [CrossRef] [Green Version]
- Guegan, H.; Robert-Gangneux, F. Molecular diagnosis of Pneumocystis pneumonia in immunocompromised patients. Curr. Opin. Infect. Dis. 2019, 32, 314–321. [Google Scholar] [CrossRef]
- Summah, H.; Zhu, Y.-G.; Falagas, M.E.; Vouloumanou, E.K.; Qu, J.-M. Use of real-time polymerase chain reaction for the diagnosis of Pneumocystis pneumonia I immunocompromised patients: A meta-analysis. Chin. Med. J. 2013, 126, 1965–1973. [Google Scholar]
- Fan, L.-C.; Lu, H.-W.; Cheng, K.-B.; Li, H.-P.; Xu, J.-F. Evaluation of PCR in Bronchoalveolar Lavage Fluid for Diagnosis of Pneumocystis jirovecii Pneumonia: A Bivariate Meta-Analysis and Systematic Review. PLoS ONE 2013, 8, e73099. [Google Scholar] [CrossRef] [Green Version]
- Fauchier, T.; Hasseine, L.; Gari-Toussaint, M.; Casanova, V.; Marty, P.M.; Pomares, C. Detection of Pneumocystis jirovecii by Quantitative PCR To Differentiate Colonization and Pneumonia in Immunocompromised HIV-Positive and HIV-Negative Patients. J. Clin. Microbiol. 2016, 54, 1487–1495. [Google Scholar] [CrossRef] [Green Version]
- Dimonte, S.; Berrilli, F.; D’Orazi, C.; D’Alfonso, R.; Placco, F.; Bordi, E.; Perno, C.; di Cave, D. Molecular analysis based on mtLSU-rRNA and DHPS sequences of Pneumocystis jirovecii from immunocompromised and immunocompetent patients in Italy. Infect. Genet. Evol. 2013, 14, 68–72. [Google Scholar] [CrossRef]
- Rudramurthy, S.M.; Sharma, M.; Sharma, M.; Rawat, P.; Ghosh, A.K.; Venkatesan, L.; Aggarwal, R.; Singh, P.; Chakrabarti, A. Reliable differentiation of Pneumocystis pneumonia from Pneumocystis colonisation by quantification of Major Surface Glycoprotein gene using real-time polymerase chain reaction. Mycoses 2017, 61, 96–103. [Google Scholar] [CrossRef]
- Maillet, M.; Maubon, D.; Brion, J.P.; François, P.; Molina, L.; Stahl, J.; Epaulard, O.; Bosseray, A.; Pavese, P. Pneumocystis jirovecii (Pj) quantitative PCR to differentiate Pj pneumonia from Pj colonization in immunocompromised patients. Eur. J. Clin. Microbiol. Infect. Dis. 2013, 33, 331–336. [Google Scholar] [CrossRef]
- Suárez, I.; Roderus, L.; van Gumpel, E.; Jung, N.; Lehmann, C.; Fätkenheuer, G.; Hartmann, P.; Plum, G.; Rybniker, J. Low prevalence of DHFR and DHPS mutations in Pneumocystis jirovecii strains obtained from a German cohort. Infection 2017, 45, 341–347. [Google Scholar] [CrossRef]
- Desoubeaux, G.; Chesnay, A.; Mercier, V.; Bras-Cachinho, J.; Moshiri, P.; Eymieux, S.; de Kyvon, M.; Lemaignen, A.; Goudeau, A.; Bailly, É. Combination of β-(1, 3)-D-glucan testing in serum and qPCR in nasopharyngeal aspirate for facilitated diagnosis of Pneumocystis jirovecii pneumonia. Mycoses 2019, 62, 1015–1022. [Google Scholar] [CrossRef]
- Groll, A.H.; Castagnola, E.; Cesaro, S.; Dalle, J.-H.; Engelhard, D.; Hope, W.W.; Roilides, E.; Styczynski, J.; Warris, A.; Lehrnbecher, T. Fourth European Conference on Infections in Leukaemia (ECIL-4): Guidelines for diagnosis, prevention, and treatment of invasive fungal diseases in paediatric patients with cancer or allogeneic haemopoietic stem-cell transplantation. Lancet Oncol. 2014, 15, e327–e340. [Google Scholar] [CrossRef]
- Morjaria, S.; Frame, J.; Franco-Garcia, A.; Geyer, A.; Kamboj, M.; Babady, N.E. Clinical Performance of (1,3) Beta-D Glucan for the Diagnosis of Pneumocystis Pneumonia (PCP) in Cancer Patients Tested With PCP Polymerase Chain Reaction. Clin. Infect. Dis. 2019, 69, 1303–1309. [Google Scholar] [CrossRef]
- Rose, S.R.; Vallabhajosyula, S.; Velez, M.G.; Fedorko, D.P.; van Raden, M.J.; Gea-Banacloche, J.C.; Lionakis, M.S. The utility of bronchoalveolar lavage beta-D-glucan testing for the diagnosis of invasive fungal infections. J. Infect. 2014, 69, 278–283. [Google Scholar] [CrossRef] [Green Version]
- de Boer, M.G.; Gelinck, L.B.; van Zelst, B.; van de Sande, W.W.; Willems, L.N.; van Dissel, J.T.; de Jonge, R.; Kroon, F.P. β-d-Glucan and S-adenosylmethionine serum levels for the diagnosis of Pneumocystis pneumonia in HIV-negative Patients: A prospective study. J. Infect. 2011, 62, 93–100. [Google Scholar] [CrossRef]
- Urabe, N.; Sakamoto, S.; Sano, G.; Ito, A.; Sekiguchi, R.; Homma, S. Serial change in serum biomarkers during treatment of Non-HIV Pneumocystis pneumonia. J. Infect. Chemother. 2019, 25, 936–942. [Google Scholar] [CrossRef]
- Geelhoed, G.W. Open lung biopsy in the diagnosis of Pneumocystis carinii pneumonia. Natl. Cancer Inst. Monogr. 1976, 43, 141–147. [Google Scholar]
- Ekren, P.K.; Töreyin, Z.N.; Nahid, P.; Doskaya, M.; Caner, A.; Turgay, N.; Zeytinoğlu, A.; Toz, S.; Bacakoğlu, F.; Guruz, Y.; et al. The association between Cytomegalovirusco-infection withPneumocystispneumonia and mortality in immunocompromised non-HIV patients. Clin. Respir. J. 2018, 12, 2590–2597. [Google Scholar] [CrossRef]
- Yu, Q.; Jia, P.; Su, L.; Zhao, H.; Que, C. Outcomes and prognostic factors of non-HIV patients with pneumocystis jirovecii pneumonia and pulmonary CMV co-infection: A Retrospective Cohort Study. BMC Infect. Dis. 2017, 17, 392. [Google Scholar] [CrossRef] [Green Version]
- Sehulster, L.; Chinn, R.Y.W. Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR. Recomm. Rep. 2003, 52, 1–42. [Google Scholar]
- Pagano, L.; Fianchi, L.; Mele, L.; Girmenia, C.; Offidani, M.; Ricci, P.; Mitra, M.E.; Picardi, M.; Caramatti, C.; Piccaluga, P.; et al. Pneumocystis carinii pneumonia in patients with malignant haematological diseases: 10 years’ experience of infection in GIMEMA centres. Br. J. Haematol. 2002, 117, 379–386. [Google Scholar] [CrossRef] [Green Version]
- Warren, E.; George, S.; You, J.; Kazanjian, P. Advances in the treatment and prophylaxis of Pneumocystis carinii pneumonia. Pharmacother. J. Hum. Pharmacol. Drug Ther. 1997, 17, 900–916. [Google Scholar]
- Castagnola, E.; Zarri, D.; Caprino, D.; Losurdo, G.; Micalizzi, C. Cotrimoxazole prophylaxis of Pneumocystis carinii infection during the treatment of childhood acute lymphoblastic leukemia-beware non compliance in older children and adolescents. Support. Care Cancer 2001, 9, 552–553. [Google Scholar] [CrossRef]
- Hughes, W.T.; Kuhn, S.; Chaudhary, S.; Feldman, S.; Verzosa, M.; Aur, R.J.; Pratt, C.; George, S.L. Successful Chemoprophylaxis for Pneumocystis carinii Pneumonitis. N. Engl. J. Med. 1977, 297, 1419–1426. [Google Scholar] [CrossRef]
- Hughes, W.T.; Rivera, G.K.; Schell, M.J.; Thornton, D.; Lott, L. Successful Intermittent Chemoprophylaxis for Pneumocystis carinii Pneumonitis. N. Engl. J. Med. 1987, 316, 1627–1632. [Google Scholar] [CrossRef]
- Rossi, M.R.; Banfi, P.; Cappuccilli, M.; Conter, V.; de Poli, D.; Piacentini, G.; Zurlo, M.G.; Masera, G. Prospective randomized comparison of two prophylactic regimens with trimethoprim-sulfamethoxazole in leukemic children: A two year study. Eur. J. Cancer Clin. Oncol. 1987, 23, 1679–1682. [Google Scholar] [CrossRef]
- Postma, A.; Kamps, W. Prevention of Pneumocystis carinii pneumonia with cotrimoxazole 18 mg/kg. Support. Care Cancer 1998, 6, 300. [Google Scholar] [CrossRef]
- Centers for Disease Control and Prevention; Infectious Disease Society of America; American Society of Blood and Marrow Transplantation. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. MMWR Recomm. Rep. 2000, 49, 1–125. [Google Scholar]
- Green, H.; Paul, M.; Vidal, L.; Leibovici, L. Prophylaxis of Pneumocystis Pneumonia in Immunocompromised Non-HIV-Infected Patients: Systematic Review and Meta-analysis of Randomized Controlled Trials. Mayo Clin. Proc. 2007, 82, 1052–1059. [Google Scholar] [CrossRef] [PubMed]
- Maertens, J.; Cesaro, S.; Maschmeyer, G.; Einsele, H.; Donnelly, J.P.; Alanio, A.; Hauser, P.M.; Lagrou, K.; Melchers, W.J.G.; Helweg-Larsen, J.; et al. ECIL guidelines for preventing Pneumocystis jirovecii pneumonia in patients with haematological malignancies and stem cell. J. Antimicrob. Chemother. 2016, 71, 2397–2404. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lindemulder, S.; Albano, E. Successful Intermittent Prophylaxis with Trimethoprim/Sulfamethoxazole 2 Days per Week for Pneumocystis carinii (jiroveci) Pneumonia in Pediatric Oncology Patients. Pediatrics 2007, 120, 2397–2404. [Google Scholar] [CrossRef]
- Ohata, Y.; Ohta, H.; Hashii, Y.; Tokimasa, S.; Ozono, K.; Hara, J. Intermittent oral trimethoprim/sulfamethoxazole on two non-consecutive days per week is effective as Pneumocystis jiroveci pneumonia prophylaxis in pediatric patients receiving chemotherapy or hematopoietic stem cell transplantation. Pediatr. Blood Cancer 2009, 52, 142–144. [Google Scholar] [CrossRef]
- Muto, T.; Takeuchi, M.; Kawaguchi, T.; Tanaka, S.; Tsukamoto, S.; Sakai, S.; Takeda, Y.; Abe, D.; Ohwada, C.; Sakaida, E.; et al. Low-dose trimethoprim–sulfamethoxazole for Pneumocystis jiroveci pneumonia prophylaxis after allogeneic hematopoietic SCT. Bone Marrow Transplant. 2011, 46, 1573–1575. [Google Scholar] [CrossRef] [Green Version]
- Agrawal, A.K.; Chang, P.P.; Feusner, J. Twice Weekly Pneumocystis jiroveci Pneumonia Prophylaxis with Trimethoprim-Sulfamethoxazole in Pediatric Patients with Acute Lymphoblastic Leukemia. J. Pediatr. Hematol. 2011, 33, e1–e4. [Google Scholar] [CrossRef]
- Stern, A.; Green, H.; Paul, M.; Vidal, L.; Leibovici, L. Prophylaxis for Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients. Cochrane Database Syst. Rev. 2014, 2014, CD005590. [Google Scholar] [CrossRef]
- Quinn, M.; Fannin, J.T.; Sciasci, J.; Bragg, A.; Campbell, P.K.; Carias, D.; Crews, K.R.; Gregornik, D.; Jeha, S.; Maron, G.; et al. Pentamidine for Prophylaxis against Pneumocystis jirovecii Pneumonia in Pediatric Oncology Patients Receiving Immunosuppressive Chemotherapy. Antimicrob. Agents Chemother. 2018, 62, 00173. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kruizinga, M.D.; Bresters, D.; Smiers, F.J.; Lankester, A.C.; Bredius, R.G.M. The use of intravenous pentamidine for the prophylaxis of Pneumocystis pneumonia in pediatric patients. Pediatr. Blood Cancer 2017, 64, e26453. [Google Scholar] [CrossRef]
- Levy, E.R.; Musick, L.; Zinter, M.S.; Lang, T.; Cowan, M.J.; Weintrub, P.S.; Dvorak, C.C. Safe and Effective Prophylaxis with Bimonthly Intravenous Pentamidine in the Pediatric Hematopoietic Stem Cell Transplant Population. Pediatr. Infect. Dis. J. 2016, 35, 135–141. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Solodokin, L.J.; Klejmont, L.M.; Scipione, M.R.; Dubrovskaya, Y.; Lighter-Fisher, J.; Papadopoulos, J. Safety and Effectiveness of Intravenous Pentamidine for Prophylaxis of Pneumocystis jirovecii Pneumonia in Pediatric Hematology/Oncology Patients. J. Pediatr. Hematol. 2016, 38, e180–e185. [Google Scholar] [CrossRef]
- Curi, D.A.; Duerst, R.E.; Badke, C.; Bell, J.; Chaudhury, S.; Kletzel, M.; Schneiderman, J.; Tse, W.T.; Muller, W.J.; Hijiya, N. IV pentamidine for Pneumocystis jiroveci pneumonia prophylaxis in pediatric allogeneic stem cell transplant patients. Bone Marrow Transplant. 2016, 51, 1394–1396. [Google Scholar] [CrossRef]
- Clark, A.; Hemmelgarn, T.; Teusink, A.; Danziger-Isakov, L. Intravenous pentamidine forPneumocystis carinii/jirovecipneumonia prophylaxis in pediatric transplant patients. Pediatr. Transplant. 2015, 19, 326–331. [Google Scholar] [CrossRef]
- Orgel, E.; Rushing, T. Efficacy and Tolerability of Intravenous Pentamidine Isethionate for Pneumocystis Jiroveci Prophylaxis in A Pediatric Oncology Population. Pediatr. Infect. Dis. J. 2014, 33, 319–321. [Google Scholar] [CrossRef]
- Demasi, J.M.; Cox, J.A.; Leonard, D.; Koh, A.Y.; Aquino, V.M. Intravenous Pentamidine Is Safe and Effective as Primary Pneumocystis Pneumonia Prophylaxis in Children and Adolescents Undergoing Hematopoietic Stem Cell Transplantation. Pediatr. Infect. Dis. J. 2013, 32, 933–936. [Google Scholar] [CrossRef]
- Kim, S.Y.; Dabb, A.A.; Glenn, D.J.; Snyder, K.M.; Chuk, M.K.; Loeb, D.M. Intravenous pentamidine is effective as second linePneumocystis pneumonia prophylaxis in pediatric oncology patients. Pediatr. Blood Cancer 2008, 50, 779–783. [Google Scholar] [CrossRef] [Green Version]
- Sweiss, K.; Anderson, J.; Wirth, S.; Oh, A.; Quigley, J.G.; Khan, I.; Saraf, S.; Haaf, C.M.; Rondelli, D.; Patel, P. A prospective study of intravenous pentamidine for PJP prophylaxis in adult patients undergoing intensive chemotherapy or hematopoietic stem cell transplant. Bone Marrow Transplant. 2017, 53, 300–306. [Google Scholar] [CrossRef] [Green Version]
- Lim, M.J.; Stebbings, A.; Lim, S.J.; Foor, K.; Hou, J.-Z.; Farah, R.; Raptis, A.; Marks, S.; Weber, D.; Im, A.; et al. IV pentamidine for primary PJP prophylaxis in adults undergoing allogeneic hematopoietic progenitor cell transplant. Bone Marrow Transplant. 2015, 50, 1253–1255. [Google Scholar] [CrossRef] [Green Version]
- Prasad, P.; Nania, J.J.; Shankar, S.M. Pneumocystis pneumonia in children receiving chemotherapy. Pediatr. Blood Cancer 2008, 50, 896–898. [Google Scholar] [CrossRef]
- Weinthal, J.; Frost, J.D.; Briones, G.; Cairo, M.S. Successful Pneumocystis carinii pneumonia prophylaxis using aerosolized pentamidine in children with acute leukemia. J. Clin. Oncol. 1994, 12, 136–140. [Google Scholar] [CrossRef]
- Mustafa, M.M.; Pappo, A.; Cash, J.; Winick, N.J.; Buchanan, G.R. Aerosolized pentamidine for the prevention of Pneumocystis carinii pneumonia in children with cancer intolerant or allergic to trimethoprim/sulfamethoxazole. J. Clin. Oncol. 1994, 12, 258–261. [Google Scholar] [CrossRef]
- Vasconcelles, M.; Bernardo, M.; King, C.; Weller, E.; Antin, J. Aerosolized pentamidine as pneumocystis prophylaxis after bone marrow transplantation is inferior to other regimens and is associated with decreased survival and an increased risk of other infections. Biol. Blood Marrow Transplant. 2000, 6, 35–43. [Google Scholar] [CrossRef]
- Marras, T.K.; Sanders, K.; Lipton, J.H.; Messner, H.A.; Conly, J.; Chan, C.K.; Marras, T.K.; Sanders, K.; Lipton, J.H.; Messner, H.A.; et al. Aerosolized pentamidine prophylaxis for Pneumocystis carinii pneumonia after allogeneic marrow transplantation: Marras et al. Pentamidine for PCP prophylaxis post BMT. Transpl. Infect. Dis. 2002, 4, 66–74. [Google Scholar] [CrossRef]
- Hughes, W.T. Use of Dapsone in the Prevention and Treatment of Pneumocystis carinii Pneumonia: A Review. Clin. Infect. Dis. 1998, 27, 191–204. [Google Scholar] [CrossRef] [Green Version]
- Maltezou, H.C.; Petropoulos, D.; Choroszy, M.; Gardner, M.; Mantzouranis, E.C.; Rolston, K.V.; Chan, K.W. Dapsone for Pneumocystis carinii prophylaxis in children undergoing bone marrow transplantation. Bone Marrow Transplant. 1997, 20, 879–881. [Google Scholar] [CrossRef] [Green Version]
- Sangiolo, D.; Storer, B.; Nash, R.; Corey, L.; Davis, C.; Flowers, M.; Hackman, R.C.; Boeckh, M. Toxicity and Efficacy of Daily Dapsone as Pneumocystis jiroveci Prophylaxis after Hematopoietic Stem Cell Transplantation: A Case-Control Study. Biol. Blood Marrow Transplant. 2005, 11, 521–529. [Google Scholar] [CrossRef] [Green Version]
- Souza, J.P.; Boeckh, M.; Gooley, T.A.; Flowers, M.E.D.; Crawford, S.W. High Rates of Pneumocystis carinii Pneumonia in Allogeneic Blood and Marrow Transplant Recipients Receiving Dapsone Prophylaxis. Clin. Infect. Dis. 1999, 29, 1467–1471. [Google Scholar] [CrossRef]
- Fanello, C.; Karema, C.; Avellino, P.; Bancone, G.; Uwimana, A.; Lee, S.J.; D’Alessandro, U.; Modiano, D. High Risk of Severe Anaemia after Chlorproguanil-Dapsone+Artesunate Antimalarial Treatment in Patients with G6PD (A-) Deficiency. PLoS ONE 2008, 3, e4031. [Google Scholar] [CrossRef] [Green Version]
- Williams, S.; Macdonald, P.; Hoyer, J.D.; Barr, R.D.; Athale, U.H. Methemoglobinemia in children with acute lymphoblastic leukemia (ALL) receiving dapsone forpneumocystis carinii pneumonia (PCP) prophylaxis: A correlation with cytochrome b5 reductase (Cb5R) enzyme levels. Pediatr. Blood Cancer 2004, 44, 55–62. [Google Scholar] [CrossRef]
- Esbenshade, A.J.; Ho, R.H.; Shintani, A.; Zhao, Z.; Smith, L.-A.; Friedman, D.L. Dapsone-induced methemoglobinemia. Cancer 2011, 117, 3485–3492. [Google Scholar] [CrossRef] [Green Version]
- Ms, R.M.M.; Pui, C.-H.; Hughes, W.T.; Flynn, P.M.; Leung, W. Prophylaxis ofPneumocystis carinii pneumonia with atovaquone in children with leukemia. Cancer 2007, 109, 1654–1658. [Google Scholar] [CrossRef]
- Shankar, S.M.; Nania, J.J. Management of Pneumocystis jiroveci Pneumonia in Children Receiving Chemotherapy. Pediatr. Drugs 2007, 9, 301–309. [Google Scholar] [CrossRef]
- Proudfoot, R.; Phillips, B.; Wilne, S. Guidelines for the Prophylaxis of Pneumocystis jirovecii Pneumonia (PJP) in Children with Solid Tumors. J. Pediatr. Hematol. 2017, 39, 194–202. [Google Scholar] [CrossRef]
- Asai, N.; Motojima, S.; Ohkuni, Y.; Matsunuma, R.; Nakashima, K.; Iwasaki, T.; Nakashita, T.; Kaneko, N.; Otsuka, Y. Early diagnosis and treatment are crucial for the survival of Pneumocystis pneumonia patients without human immunodeficiency virus infection. J. Infect. Chemother. 2012, 18, 898–905. [Google Scholar] [CrossRef]
- Bartlett, M.S.; Queener, S.F.; Shaw, M.M.; Richardson, J.D.; Smith, J.W. Pneumocystis carinii is resistant to imidazole antifungal agents. Antimicrob. Agents Chemother. 1994, 38, 1859–1861. [Google Scholar] [CrossRef] [Green Version]
- Lee, W.-S.; Hsueh, P.-R.; Hsieh, T.-C.; Chen, F.-L.; Ou, T.-Y.; Jean, S.-S. Caspofungin salvage therapy in Pneumocystis jirovecii pneumonia. J. Microbiol. Immunol. Infect. 2017, 50, 547–548. [Google Scholar] [CrossRef] [Green Version]
- Ceballos, M.E.; Ortega, M.; Andresen, M.; Wozniak, A.; García, P.; Balcells, M.E. Successful treatment with echinocandin in an HIV-infected individual failing first-line therapy for Pneumocystis jirovecii pneumonia. AIDS 2011, 25, 2192–2193. [Google Scholar] [CrossRef]
- Maschmeyer, G.; Helweg-Larsen, J.; Pagano, L.; Robin, C.; Cordonnier, C.; Schellongowski, P.; Akova, M.; Aljurf, M.; Averbuch, D.; Barnes, R.; et al. ECIL guidelines for treatment of Pneumocystis jirovecii pneumonia in non-HIV-infected haematology patients. J. Antimicrob. Chemother. 2016, 71, 2405–2413. [Google Scholar] [CrossRef]
- Richards, C.G.; E Wakefield, A.; Mitchell, C.D. Detection of pneumocystis DNA in nasopharyngeal aspirates of leukaemic infants with pneumonia. Arch. Dis. Child. 1994, 71, 254–255. [Google Scholar] [CrossRef] [Green Version]
- Eroglu-Ertugrul, N.G.; Yalcin, E.; Oguz, B.; Ocal, T.; Kuskonmaz, B.; Emiralioglu, N.; Dogru-Ersoz, D.; Ozcelik, U.; Tezcan, I.; Kiper, N. The value of flexible bronchoscopy in pulmonary infections of immunosuppressed children. Clin. Respir. J. 2019, 14, 78–84. [Google Scholar] [CrossRef]
- le Gal, S.; Robert-Gangneux, F.; Pépino, Y.; Belaz, S.; Damiani, C.; Guéguen, P.; Pitous, M.; Virmaux, M.; Lissillour, E.; Pougnet, L.; et al. A misleading false-negative result of Pneumocystis real-time PCR assay due to a rare punctual mutation: A French multicenter study. Med. Mycol. 2016, 55, 180–184. [Google Scholar] [CrossRef] [Green Version]
- Matsumura, Y.; Shindo, Y.; Iinuma, Y.; Yamamoto, M.; Shirano, M.; Matsushima, A.; Nagao, M.; Ito, Y.; Takakura, S.; Hasegawa, Y.; et al. Clinical characteristics of Pneumocystis pneumonia in non-HIV patients and prognostic factors including microbiological genotypes. BMC Infect. Dis. 2011, 11, 76–79. [Google Scholar] [CrossRef] [Green Version]
- Vanspauwen, M.J.; Knops, V.E.J.; Bruggeman, C.A.; van Mook, W.N.K.A.; Linssen, C.F.M. Molecular epidemiology of Pneumocystis jiroveci in human immunodeficiency virus-positive and -negative immunocompromised patients in The Netherlands. J. Med. Microbiol. 2014, 63, 1294–1302. [Google Scholar] [CrossRef] [Green Version]
- Kay, R.; Dubois, R.E. Clindamycin/Primaquine Therapy and Secondary Prophylaxis Against Pneumocystis carinii Pneumonia in Patients With AIDS. South. Med. J. 1990, 83, 403–404. [Google Scholar] [CrossRef]
- Belfield, K.D.; Tichy, E.M. Review and drug therapy implications of glucose-6-phosphate dehydrogenase deficiency. Am. J. Heal. Pharm. 2018, 75, 97–104. [Google Scholar] [CrossRef]
- Riley, T.V.; Golledge, C.L. Clindamycin and pseudomembranous colitis. Lancet 1995, 346, 639. [Google Scholar] [CrossRef]
- Pareja, J.G.; Garland, R.; Koziel, H. Use of Adjunctive Corticosteroids in Severe Adult Non-HIV Pneumocystiscarinii Pneumonia. Chest 1998, 113, 1215–1224. [Google Scholar] [CrossRef]
- Delclaux, C.; Zahar, J.-R.; Amraoui, G.; Leleu, G.; Lebargy, F.; Brochard, L.; Schlemmer, B.; Brun-Buisson, C. Corticosteroids as adjunctive therapy for severe Pneumocystis carinii pneumonia in non-human immunodeficiency virus-infected patients: Retrospective study of 31 patients. Clin. Infect. Dis. 1999, 29, 670–672. [Google Scholar] [CrossRef]
- Limper, A.H.; Knox, K.S.; Sarosi, G.A.; Ampel, N.M.; Bennett, J.E.; Catanzaro, A.; Davies, S.F.; Dismukes, W.E.; Hage, C.A.; Marr, K.A.; et al. An Official American Thoracic Society Statement: Treatment of Fungal Infections in Adult Pulmonary and Critical Care Patients. Am. J. Respir. Crit. Care Med. 2011, 183, 96–128. [Google Scholar] [CrossRef] [Green Version]
- Rilinger, J.; Staudacher, D.L.; Rieg, S.; Duerschmied, D.; Bode, C.; Wengenmayer, T. Extracorporeal membrane oxygenation in Pneumocystis jirovecii pneumonia: Outcome in HIV and non-HIV patients. Crit. Care 2019, 23, 356. [Google Scholar] [CrossRef] [Green Version]
- Slater, A.; Nichani, S.H.; Macrae, D.; Wilkinson, K.A.; Novelli, V.; Tasker, R.C. Surfactant adjunctive therapy for Pneumocystis carinii pneumonitis in an infant with acute lymphoblastic leukaemia. Intensiv. Care Med. 1995, 21, 261–263. [Google Scholar] [CrossRef]
- Lawrence, S.J.; Sadarangani, M.; Jacobson, K. Pneumocystis jirovecii Pneumonia in Pediatric Inflammatory Bowel Disease: A Case Report and Literature Review. Front. Pediatr. 2017, 5, 161. [Google Scholar] [CrossRef]
- Tragiannidis, A.; Kyriakidis, I.; Zündorf, I.; Groll, A.H. Invasive fungal infections in pediatric patients treated with tumor necrosis alpha (TNF-α) inhibitors. Mycoses 2017, 60, 222–229. [Google Scholar] [CrossRef]
- Kyriakidis, I.; Tragiannidis, A.; Zündorf, I.; Groll, A.H. Invasive fungal infections in paediatric patients treated with macromolecular immunomodulators other than tumour necrosis alpha inhibitors. Mycoses 2017, 60, 493–507. [Google Scholar] [CrossRef]
Feature | PJP in Children with Leukemia | PJP in Children with AIDS |
---|---|---|
Number of organisms in BAL fluid | Low | High |
Clinical presentation | Acute, severe | Subacute |
Air cysts, spontaneous Pneumothorax and pneumomediastinum | Uncommon | Common |
Possible diagnostic delay | Usually longer | Shorter |
Mortality * | 28–53% | 17–30% |
Ref. | Country | Study Period | Number of Patients | Number of PJP Cases | ||
---|---|---|---|---|---|---|
1 | Quinn M, et al. | [101] | Memphis, TN, USA | 1/2007–8/2014 | 508 (158 HSCT, 262 ST, 88 L/L) * | 0 cases of probable or proven PJP, 4 cases (0.8%) of possible PJP |
2 | Kruizinga MD, et al. | [102] | The Netherlands | 5/2011–9/2016 | 106 | 1 case of PJP |
3 | Levy ER, et al. | [103] | San Francisco, CA, USA | 12/2006–6/2013 | 111 (all HSCT) | 0 cases of PJP |
4 | Solodokin LJ, et al. | [104] | Valhalla, NY, USA | 1/2009–7/2014 | 121 | 0 cases of PJP |
5 | Curi DA, et al. | [105] | Chicago, IL, USA | 1/2007–12/2012 | 142 (all HSCT) | 0 cases of PJP |
6 | Clark A, et al. | [106] | Cincinnati, OH, USA | 1/2010–7/2013 | 333 (all HSCT) | 1 case of PJP |
7 | Orgel E, et al. | [107] | Los Angeles, CA, USA | 1/2005–12/2010 | 117 | 1 case of possible PJP, 1 case of proven PJP |
8 | DeMasi JM, et al. | [108] | Dallas, TX, USA | 1/2005–10/2011 | 137 (all HSCT, 167 transplants **) | 0 cases of PJP |
9 | Kim SY, et al. | [109] | USA, Baltimore MA | 1/2001–12/2006 | 232 (106 HSCT) | 3 cases of PJP, 2 in HSCT recipients |
Cotrimoxazole per os (A-I level of evidence per ECIL-5) * [95] | As trimethoprim (TMP) 5 mg/kg (150 mg/m2) and sulfamethoxazole (SMX) 25 mg/kg (750 mg/m2), divided once or twice/day for two to three days per week. Maximum daily dose is 320 mg TMP and 1600 mg SMX. ** Duration of prophylaxis is from induction to end of maintenance (ALL), from engraftment to 6 months and while immunosuppression is ongoing (HSCT recipients), and through the duration of chemotherapy in patients with AML and solid tumors. |
Pentamidine aerosolized (B-II level of evidence per ECIL-5) | 300 mg once a month. To be avoided in children <5 years of age due to concerns of inability to inhale the entire dose. The drug needs to be administered through a Respirgard II jet or similar nebulizer that generates drug particles <4 µm in diameter. Duration of prophylaxis, as per cotrimoxazole. |
Pentamidine intravenously (C-II level of evidence per ECIL-5) | 4 mg/kg/day, once/day every 28 days. Duration of prophylaxis, as per cotrimoxazole. |
Dapsone per os (C-II level of evidence per ECIL-5) | 2–4 mg/kg/day. Maximum daily dose 100 mg divided twice/day (50 mg bid). Duration of prophylaxis, as per cotrimoxazole. |
Atovaquone per os (B-II level of evidence per ECIL-5) | 30 mg/kg/day for patients aged 1–3 months and 3–12 years. In infants aged 4–24 months, the dose is 45 mg/kg/day. It is administered with a meal as a single daily dose. For adolescents ≥13 years and adults, the dose is 1500 mg once/day. Duration of prophylaxis, as per cotrimoxazole. |
Cotrimoxazole (TMP/SMX) | 15–20 mg/kg/day trimethoprim (TMP) (maximum TMP dose 960 mg/day) and 75–100 mg/kg/day sulfamethoxazole (SMX) orally or intravenously divided every 6–8 h for 21 days |
Clindamycin plus primaquine | Clindamycin 30–40 mg/kg/day orally or intravenously divided every 6–8 h (maximum single dose 600 mg) and primaquine 0.25 mg/kg/day (maximum 15 mg/day) for 21 days |
Pentamidine | 4 mg/kg/day IV once/day (maximum 300 mg/day) for 21 days |
Atovaquone | 30 mg/kg/day orally once/day in children <3months and >24 months and 45 mg/kg/day orally divided every 12 h in children 4–24 months for 21 days |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2020 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Mantadakis, E. Pneumocystis jirovecii Pneumonia in Children with Hematological Malignancies: Diagnosis and Approaches to Management. J. Fungi 2020, 6, 331. https://doi.org/10.3390/jof6040331
Mantadakis E. Pneumocystis jirovecii Pneumonia in Children with Hematological Malignancies: Diagnosis and Approaches to Management. Journal of Fungi. 2020; 6(4):331. https://doi.org/10.3390/jof6040331
Chicago/Turabian StyleMantadakis, Elpis. 2020. "Pneumocystis jirovecii Pneumonia in Children with Hematological Malignancies: Diagnosis and Approaches to Management" Journal of Fungi 6, no. 4: 331. https://doi.org/10.3390/jof6040331
APA StyleMantadakis, E. (2020). Pneumocystis jirovecii Pneumonia in Children with Hematological Malignancies: Diagnosis and Approaches to Management. Journal of Fungi, 6(4), 331. https://doi.org/10.3390/jof6040331