Abstract
Patients with compromised cellular immunity are at high risk for Pneumocystis jirovecii infection as well as other opportunistic pathogens such as the endemic mycoses. Histoplasma capsulatum is of particular concern to the histopathologist considering a diagnosis of Pneumocystis pneumonia since these two organisms are of similar size and can have overlapping morphologic features. Further complicating the diagnosis, P. jirovecii can induce multiple patterns of lung injury, including granulomatous inflammation, which is typically seen in H. capsulatum infection. Special stains (e.g., GMS) can help distinguish between the two organisms but are not always definitive. Molecular microbiology assays and fluorescent antibody staining for P. jirovecii are rapid, sensitive, and specific methods, which are valuable when an infectious process is suspected in an immunocompromised patient.
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References
Manos NE, Ferebee SH, Kerschbaum WF. Geographic variation in the prevalence of histoplasmin sensitivity. Dis Chest. 1956;29(6):649–68.
Houston S. Tropical respiratory medicine. 3. Histoplasmosis and pulmonary involvement in the tropics. Thorax. 1994;49(6):598–601.
Oladele RO, Ayanlowo OO, Richardson MD, Denning DW. Histoplasmosis in Africa: an emerging or a neglected disease? PLoS Negl Trop Dis. 2018;12(1):e0006046.
Goodwin RA, Loyd JE, Des Prez RM. Histoplasmosis in normal hosts. Medicine (Baltimore). 1981;60(4):231.
Medrano FJ, Montes-Cano M, Conde M, de la Horra C, Respaldiza N, Gasch A, et al. Pneumocystis jirovecii in general population. Emerg Infect Dis. 2005;11(2):245–50.
Roux A, Canet E, Valade S, Gangneux-Robert F, Hamane S, Lafabrie A, et al. Pneumocystis jirovecii pneumonia in patients with or without AIDS, France. Emerg Infect Dis. 2014;20(9):1490–7.
Liu Y, Fahle GA, Kovacs JA. Inability to culture Pneumocystis jirovecii. MBio. 2018;129(3):e00939–18.
Kuhlman JE, Kavuru M, Fishman EK, Siegelman SS. Pneumocystis carinii pneumonia: spectrum of parenchymal CT findings. Radiology. 1990;175(3):711–4.
Kennedy CA, Goetz MB. Atypical roentgenographic manifestations of Pneumocystis carinii pneumonia. Arch Intern Med. 1992;152(7):1390–8.
Gurney JW, Conces DJ. Pulmonary histoplasmosis. Radiology. 1996;199(2):297–306.
Travis WD, Pittaluga S, Lipschik GY, Ognibene FP, Suffredini AF, Masur H, et al. Atypical pathologic manifestations of Pneumocystis carinii pneumonia in the acquired immune deficiency syndrome. Review of 123 lung biopsies from 76 patients with emphasis on cysts, vascular invasion, vasculitis, and granulomas. Am J Surg Pathol. 1990;14(7):615–25.
Wilson JW, Limper AH, Grys TE, Karre T, Wengenack NL, Binnicker MJ. Pneumocystis jirovecii testing by real-time polymerase chain reaction and direct examination among immunocompetent and immunosuppressed patient groups and correlation to disease specificity. Diagn Microbiol Infect Dis. 2011;69(2):145–52.
Church DL, Ambasta A, Wilmer A, Williscroft H, Ritchie G, Pillai DR, et al. Development and validation of a Pneumocystis jirovecii real-time polymerase chain reaction assay for diagnosis of Pneumocystis pneumonia. Can J Infect Dis Med Microbiol. 2015;26(5):263–7.
Gomez CA, Budvytiene I, Zemek AJ, Banaei N. Performance of targeted fungal sequencing for culture-independent diagnosis of invasive fungal disease. Clin Infect Dis. 2017;65(12):2035–41.
Choe PG, Kang YM, Kim G, Park WB, Park SW, Kim HB, et al. Diagnostic value of direct fluorescence antibody staining for detecting Pneumocystis jirovecii in expectorated sputum from patients with HIV infection. Med Mycol. 2014;52(3):326–30.
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Mays, J.A., Lieberman, J.A., Xu, H. (2022). Pneumocystis jirovecii Pneumonia Versus Histoplasmosis. In: Xu, H., Ricciotti, R.W., Mantilla, J.G. (eds) Practical Lung Pathology. Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-031-14402-8_53
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