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Update on Diagnosis of Pneumocystis Pulmonary Infections

  • Advances in Diagnosis of Invasive Fungal Infections (U Binder, Section Editor)
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Abstract

Pneumocystis jirovecii is a widespread fungal colonizer of the human lung. Proliferation of the pathogen in the alveoli is controlled by the immune system in healthy individuals. When the immune system is impaired, pneumocystosis can emerge, resulting in a pulmonary infection. Formerly, the disease occurred mainly in acquired immune deficiency syndrome (AIDS) patients, accompanied by a high mortality. Now it is increasingly seen in patients with immunosuppressive treatment. Traditionally, laboratory diagnosis is based on the microscopic detection of cysts and trophic forms of P. jirovecii in respiratory samples. Quantitative PCR-based methods will revolutionize laboratory diagnosis. However, cutoffs have to be established to discriminate between colonization (clinically irrelevant) and infection. Furthermore, the data on the serological detection of (1→3)-ß-D-glucan to diagnose or exclude pneumocystosis is promising.

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Acknowledgments

We thank Pedrina Gonçalves Vidigal and David Killengray for careful review of the English text.

Compliance with Ethics Guidelines

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Conflict of Interest

PM Rath has received research support from Pfizer and Forest, and a speaker honorarium from Roche Diagnostics.

J Steinmann has received research support from Pfizer and Forest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Institute of Medical Microbiology, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany

    Peter-Michael Rath & Joerg Steinmann

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  1. Peter-Michael Rath
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Correspondence to Peter-Michael Rath.

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Rath, PM., Steinmann, J. Update on Diagnosis of Pneumocystis Pulmonary Infections. Curr Fungal Infect Rep 8, 227–234 (2014). https://doi.org/10.1007/s12281-014-0188-8

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