Explore
• Nonresolving pneumonia may be because of less common pathogens, or feature other conditions, and requires more detailed investigation. • Pediatric pneumonia is also common, and first-line treatment is still amoxicillin, followed closely by cephalosporins or macrolides.
What is the first line treatment for pneumonia?
- if the patient needed to return to their doctor for more of the same antibiotic
- if the patient needed a different antibiotic
- if the patient was either sent to an emergency room or was hospitalized
How effective is azithromycin for treating pneumonia?
Top 10 List of Common Infections Treated with Antibiotics
- Acne
- Bronchitis
- Conjunctivitis (Pink Eye)
- Otitis Media (Ear Infection)
- Sexually Transmitted Diseases (STD’s)
- Skin or Soft Tissue Infection
- Streptococcal Pharyngitis (Strep Throat)
- Traveler’s diarrhea
- Upper Respiratory Tract Infection
- Urinary Tract Infection (UTI)
What are the common antibiotics for pneumonia?
Substances
- Acetamides
- Anti-Bacterial Agents
- Oxazolidinones
- Vancomycin
- Linezolid
What are the treatments for MRSA pneumonia?
What is the choice of treatment for pneumocystis pneumonia?
PCP must be treated with prescription medicine. Without treatment, PCP can cause death. The most common form of treatment is trimethoprim/sulfamethoxazole (TMP/SMX), which is also known as co-trimoxazole and by several different brand names, including Bactrim, Septra, and Cotrim.
What is the recommended first line treatment for pneumocystis pneumonia?
Trimethoprim-sulfamethoxazole (TMP-SMX) is the recommended prophylactic agent for PCP (AI). One double-strength TMP-SMX tablet daily is the preferred regimen (AI), but one single-strength tablet daily45 is also effective and may be better tolerated than the double-strength tablet (AI).
What is the major side effect of the prophylactic treatment for pneumocystis jiroveci pneumonia?
Side effects include cough and bronchospasm. The potential for extrapulmonary Pneumocystis manifestations and apical lung disease exists. In addition, aerosolized pentamidine may diminish the diagnostic sensitivity of sputum induction and bronchoalveolar lavage.
What can happen if pneumocystis pneumonia is not treated?
Your immune system may be weakened by HIV/AIDS, cancer, organ transplant, medicines that suppress the immune system, or another condition that causes the immune system to not function well. PCP takes advantage of your weak immune system to attack your lungs. If not treated right away, PCP can be severe and even fatal.
What is the preferred method of diagnosis for Pneumocystis Jiroveci?
The gold standard method for the diagnosis of PCP mainly relies on microscopic detection for cysts in respiratory specimens; that is not sensitive enough [8]. Polymerase chain reaction (PCR) has been reported as a useful tool to assess Pneumocystis infection by detecting specimens from the respiratory tract.
What is Pneumocystis prophylaxis?
Pneumocystis jirovecii, despite its classification as a fungus, is susceptible to several antibacterial and antiparasitic drugs that can be used for prevention of infection among patients at high risk for PCP. The agent most commonly used for prophylaxis is trimethoprim/sulfamethoxazole (TMP/SMX).
Why was pneumocystis reclassified as a fungus?
Pneumocystis pneumonia (PcP) in humans is caused by Pneumocystis jirovecii, which has recently been reclassified as a fungus because its cell wall composition and nucleotide sequences are more similar to those of fungi. PcP occurs only in immunocompromised individuals such as those with AIDS.
What is the prognosis of Pneumocystis pneumonia?
Pneumocystis pneumonia can be life threatening. It can cause respiratory failure that can lead to death. People with this condition need early and effective treatment. For moderate to severe pneumocystis pneumonia in people with HIV/AIDS, the short term use of corticosteroids has decreased the incidence of death.
What is the difference between pneumonia and pneumocystis?
General Discussion. Pneumocystis pneumonia is a type of infection of the lungs (pneumonia) in people with a weak immune system. It is caused by a yeast-like fungus called Pneumocystis jirovecii (PJP). People with a healthy immune system don't usually get infected with PCP.
Is pneumocystis pneumonia fatal?
PCP takes advantage of your weak immune system to attack. If not treated right away, PCP can be severe and even fatal.
Is pneumocystis pneumonia contagious?
Is Pneumocystis Pneumonia Contagious? PCP is contagious. The fungus that causes it can spread from person to person through the air. People can spread the disease even when they're healthy and have no symptoms.
Why was Pneumocystis carinii renamed?
The common AIDS-related opportunistic infection Pneumocystis carinii pneumonia has been renamed Pneumocystis jiroveci pneumonia to more accurately identify the fungus that causes the infection.
What drugs are associated with pneumocystis pneumonia?
Classically, steroids and other cytotoxic agents such as methotrexate, cyclosporine and cyclophosphamide have also been associated with the development of Pneumocystispneumonia [Hardy et al. 1984; Perruquet et al. 1983]. However, new immunomodulating agents such as TNF-α inhibitors and other monoclonal antibodies have also more recently been implicated [Segal et al. 2008; Lahiff et al. 2007]. A list of the most frequent drugs associated with the development of Pneumocystispneumonia is given in Table 1. It is important to be aware that new immunosuppressant agents are continuously being developed that may enhance the potential risk of developing Pneumocystispneumonia. Therefore, a high index of suspicion should be maintained in patients who are receiving or who have taken immunosuppressants in the past. This is particularly true if the underlying medical condition itself may also affect their overall immune competency.
What is pneumocystis pneumonia?
Pneumocystisencompasses a genus of opportunistic fungal pathogens that cause potentially lethal pneumonia in immunocompromised hosts. Although the organism was discovered in the early 1900s, the first cases of Pneumocystispneumonia in humans were initially recognized in Central Europe after the Second World War, in premature and malnourished infants. This unusual lung infection was known as plasma cellular interstitial pneumonitis of the newborn, and was characterized by severe respiratory distress and cyanosis with little or no fever and no pathognomic physical signs [Baar, 1955]. At that time, only anecdotal cases were reported in adults. Usually these patients had an underlying malignancy that led to a malnourished state. In the 1960–1970s, additional cases were described in adults and children with hematological malignancies, but Pneumocystispneumonia was still considered a rare disease. However, in the 1980s, with the onset of the HIV epidemic, the prevalence of Pneumocystisincreased dramatically and became widely recognized as an opportunistic infection that caused often-lethal pneumonia in patients with impaired immunity. During this time period, prophylaxis against this organism was more generally instituted in high-risk patients [Fischl et al. 1988]. In the 1990s, with widespread use of prophylaxis and the initiation of highly active antiretroviral therapy (HAART) in the treatment of HIV-infected patients, the number of cases in this specific population decreased. However, Pneumocystispneumonia still remains an important cause of severe pneumonia in patients with HIV infection and is still considered a principal AIDS-defining illness [Kaplan et al. 2000; Jones et al. 1999].
How long have pneumocystis co-evolved?
Current concepts propose that Pneumocystisspecies have likely co-evolved and co-existed with their respective mammalian hosts for thousands of years (as reviewed by Aliouat-Denis et al. [2008]). However, it was not until 1909 that Carlos Chagas first described members of this genus when working in a guinea-pig model of trypanosome infection. Chagas initially believed that he had found a new type of trypanosomal organism or life form. Antonio Carini came to the same conclusion 1 year later when he identified similar organisms in the lungs of his rat colony. It was not until 1912 that the Delanoës working at the Pasteur Institute in Paris recognized that Pneumocystisin rat represented a unique species and christened this organism Pneumocystis cariniiin honor of Antonio Carini. Despite the knowledge of its existence in animals, the first human cases were not described until 1942 by two Dutch investigators, Van der Meer and Brug [Van der Meer and Brug, 1942]. In 1952, Vanek and Jírovec reported that Pneumocystis“carinii”, later renamed Pneumocystis jiroveci, was the cause of interstitial pneumonia in neonates [Vanek and Jírovec, 1952]. The persisting belief of that era was that Pneumocystiswas a protozoan and was classified as such for many years. This was likely due to the existence of two life forms that are morphologically parallel to other protozoan organisms, as well as its response to the antiprotozoan medication pentamidine. Despite this prevailing theory, Giese is first credited with proposing that Pneumocystismay be a yeast and that the foamy material described in the airway of these patients were spores [Giese, 1953]. However, it was not until 1988 when Edman and colleagues sequenced the small ribosomal RNA subunit that Pneumocystisspecies were correctly classified as ascomycetous fungi [Edman et al. 1988].
What are the two types of life forms of a pneumocystis?
Ultrastructural studies of animal and human derived organisms have provide some insight into the life cycle of Pneumocystisand have established that there are at least two different life forms, the trophic form and the cyst . The trophic form generally measures about 2 μm, possesses a single nucleus, and is surrounded by a plasma membrane. In contrast, the cyst is significantly larger, approximately 8–10 μm in size, contains up to eight intracystic bodies and is surrounded by a characteristic thick cyst wall. Upon rupture of the wall, known as excystment, the intracystic bodies are released to become new trophic forms of the organism. The Pneumocystiscyst wall is formed largely of β-glucans, a complex branching polysaccharide, but other components such as mannoproteins, chitins, and other proteins are also present. The main function of this wall is to confer rigidity and support for the organism, and putatively, to protect the organism from harsh environmental conditions outside the host. The maintenance of the cyst wall is a dynamic process of formation and degradation. While the cyst wall is essential to provide rigidity and viability of the organism, degradation of this wall is also necessary during excystment for the organism to complete its life cycle. To facilitate this dynamic process, β-glucan synthetases facilitate formation of the β−1,3-glucan homopolymers that comprise the cysts wall, and β-glucanases and other proteins drive the active process of degradation and restructuring of the wall. Our group first described the Pneumocystis PcGsc1gene responsible for glucan synthesis, and recently characterized the PcEng2β−1,3-endoglucanase that participates in cell wall remodeling [Villegas et al. 2009; Kottom and Limper, 2000]. Such enzymes responsible for cell wall integrity are essential to the Pneumocystislife cycle, and may represent attractive targets for future therapeutic strategies. This is noteworthy, since emerging resistance to current therapeutic agents has been described recently (see the treatmentsection for further details).
What is the best diagnostic tool for pneumonia?
The single most important diagnostic tool for Pneumocystisinfection is a high clinical suspicion. In the right clinical setting, an immunosuppressed patient with new onset of dyspnea or new symptoms of pneumonia, with or without radiological findings, should prompt further evaluation, particularly if they are not receiving chemoprophylaxis. Since Pneumocystiscannot be cultured, the gold standard for diagnosis is microscopic visualization of the organism. Traditionally different stains have been used to identify either the trophic form (Gram–Weigert, Wright–Giemsa or modified Papanicolaou stains) or the cyst forms (calcofluor white, cresyl echt violet, Gomori methenamine silver or toluidine blue) (Figure 2). However, the most common technique used currently in the majority of the laboratories is fluorescein-conjugated monoclonal antibodies. Sensitivity of these assays depends on several factors such as the type and quality of the sample (BAL versussputum versustissue), the number of organisms present, and the experience of the laboratory staff with the particular assay. In addition, all of these tests have their own advantages and disadvantages. For instance, calcofluor white has the advantages of being quick, convenient, and can identify the presence of other concomitant fungus. However, the main disadvantage of calcofluor is that this stain requires reviewer expertise for correct interpretation. On the other hand, the immunofluorescent antibody technique is advantageous in that it can detect both life forms of Pneumocystisand is also slightly more sensitive. However, immune fluorescence is more time consuming, and nonspecific staining can also occur [Procop et al. 2004]. Therefore, for those laboratories that use immunofluorescence as first-line test, confirmation with a second method is generally recommended [Procop et al. 2004]. Direct hematoxylin and eosin tissue examination frequently reveals frothy intra-alveolar exudates containing organisms, which can be further confirmed with either methenamine silver stain or immune staining (Figure 3).
How are pneumocystis transmitted?
The most commonly accepted theory is that infectious organisms are transmitted as aerosolized particles from host to host. However, the exact mechanisms of infection continue to be debated. Some investigators propose a model of initial infection in infancy or early childhood, with reactivation later in life during periods of immune suppression. In contrast, other investigators propose that while initial infection is nearly universal in early childhood, the infection is actually re-acquired again, later in life, if the host lacks T-cell-based immune responses necessary for effective defense. Observations that support the first theory are from the fact that it is not unusual to detect the presence of Pneumocystisin otherwise healthy animals [Demanche et al. 2005] implying that otherwise normal healthy hosts may serve as a reservoir for infection. Additional data in both animal models, and humans, indicate that exposure and colonization can occur very early in life, and may further support that reactivation later in life is possible [Icenhour et al. 2002].
What is the cause of pneumonia?
This unusual lung infection was known as plasma cellular interstitial pneumonitis of the newborn, and was characterized by severe respiratory distress and cyanosis with little or no fever and no pathognomic physical signs. At that time, only anecdotal cases were reported in adults and usually these patients had a baseline malignancy that led to a malnourished state. In the 1960–1970s additional cases were described in adults and children with hematological malignancies, but Pneumocystispneumonia was still considered a rare disease. However, in the 1980s, with the onset of the HIV epidemic , Pneumocystisprevalence increased dramatically and became widely recognized as an opportunistic infection that caused potentially life-treating pneumonia in patients with impaired immunity. During this time period, prophylaxis against this organism was more generally instituted in high-risk patients. In the 1990s, with widespread use of prophylaxis and the initiation of highly active antiretroviral therapy (HAART) in the treatment of HIV-infected patients, the number of cases in this specific population decreased. However, Pneumocystispneumonia still remains an important cause of severe pneumonia in patients with HIV infection and is still considered a principal AIDS-defining illness. Despite the decreased number of cases among HIV-infected patients over the past decade, Pneumocystispneumonia continues to be a serious problem in immunodeficient patients with other immunosuppressive conditions. This is mostly due to increased use of immunosuppressive medications to treat patients with autoimmune diseases, following bone marrow and solid organ transplantation, and in patients with hematological and solid malignancies. Patients with hematologic disorders and solid organ and hematopoietic stem cell transplantation are currently the most vulnerable groups at risk for developing this infection. However, any patient with an impaired immunity, such as those receiving moderate doses of oral steroids for greater than 4 weeks or those receiving other immunosuppressive medications are at also at significant risk.
What Is Pneumocystis Pneumonia?
Pneumocystis pneumonia (PCP) is a serious infection that causes inflammation and fluid buildup in your lungs. It's brought on by a fungus called Pneumocystis jirovecii that spreads through the air.
What are the risk factors for pneumocystis pneumonia?
PCP usually happens in people who've had an organ transplant, who have HIV, who have blood cancers, or who take certain drugs for autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and multiple sclerosis.
How many times more likely to get PCP than HIV?
You're most likely to get PCP when your CD4 cell count (a type of white blood cell) is less than 200. People who have HIV and get PCP are eight times more likely to need to stay in the hospital than those who get PCP but don’t have HIV. Even with treatment, PCP can be deadly for people who have AIDS. Influenza.
What is the best medicine for low oxygen?
Dapsone ( Aczone) with or without trimethoprim ( Primsol) Pentamidine ( NebuPent, Pentam) that you breathe in through a machine called a nebulizer (You could also get a shot if your infection is very serious.) Corticosteroids can help when you have low oxygen levels. Pneumocystis Pneumonia Prevention.
What test is used to test for fungus?
You might also get a chest X-ray or blood tests to check for low oxygen levels or high levels of something called beta-D-glucan. Pneumocystis Pneumonia Treatment.
What diseases can affect your lungs?
Other HIV-related diseases. Conditions like disseminated histoplasmosis, cytomegalovirus, and Kaposi sarcoma can also affect your lungs. Pneumocystis Pneumonia Diagnosis and Tests. A technician will use a microscope to look for traces of the fungus in fluid or tissue from your lungs.
What is the best medicine for PCP?
Doctors usually treat PCP with two antibiotics, trimethoprim and sulfamethoxazole, also known as TMP/SMX ( Bactrim, Cotrim, Septra ). Depending how sick you are, you'll get them in pills to swallow or through a needle in your vein (by IV) at the hospital. Other drugs that fight the infection include:
What is pneumocystis pneumonia?
Pneumocystis pneumonia or PCP is a fungal infection in one or both lungs. It is common in people who have a weak immune system, such as people who have AIDS.
How is PCP treated?
Severe PCP is often treated in a hospital with antibiotics given in an IV (intravenously or into a vein).
What causes PCP?
The fungus Pneumocystis jiroveci causes PCP. Many people live with this fungus in their lungs every day. It’s common all over the world. It usually causes little to no trouble for people with healthy immune systems. But if your immune system is weakened by HIV/AIDS, cancer, organ transplant, medicines that suppress the immune system, or another condition that causes the immune system to not function well, you have a greater chance of getting PCP. PCP takes advantage of your weak immune system to attack.
What are the symptoms of PCP?
Symptoms of PCP may develop over a period of weeks or months. The most common symptoms to watch for include:
What is a PCP infection?
Key points about PCP. PCP is an infection in one or both of the lungs caused by a fungus. A weak immune system is what puts a person at risk for PCP. The most common symptoms of PCP are sudden start of fever, cough, trouble breathing that often gets worse with activity, dry cough with little or no mucus, and chest discomfort.
What is the best medicine for PCP?
You will get an intravenous (IV) medicine that is a combination of 2 antibiotics. They are trimethoprim (TMP) and sulfamethoxazole (SMX). Other medicines are available to treat the condition.
Can you get PCP from smoking?
If you have a weak immune system, your healthcare provider may give you medicine to prevent PCP before it happens. Smokers are also at a greater risk of getting PCP. If you smoke, quitting will make your lungs healthier. It will also help keep you from getting lung infections like PCP.
How long does it take for pneumocystis to show symptoms?
Symptoms of pneumocystis pneumonia come on gradually in many people, and it can take weeks to notice an onset of symptoms.
How to treat PCP at home?
If you have a mild case of PCP, you'll be able to treat yourself at home by taking prescription medication such as Bactrim. If your case falls in the moderate category, you will be given a prescription steroid to help reduce the inflammation and damage in your lungs.
What is the cause of PCP?
PCP is caused by a tiny fungus called Pneumocystis jirovecii that is common in the environment. Pneumocystis pneumonia has a long recorded history, going as far back as 1909. In the 1940s and 1950s, pneumocystis pneumonia was the cause of the pneumonia epidemics affecting premature and malnourished infants. In the 1980s, PCP became the leading ...
What are the risks of PCP?
PCP can be a life-threatening condition for people with weakened immune systems. Certain conditions and medications can increase your risk for PCP, including but not limited to: 1 Previous Pneumocystis jirovecii infection 2 HIV 3 Cancer—especially cancers that affect the blood, like leukemia 4 Organ transplant 5 Stem cell transplant 6 Rheumatic diseases 7 Immunosuppressive medications 8 Severe malnutrition
What is the term for a condition in which fluid builds up in the lungs and causes inflammation?
Pneumocystis pneumonia —often referred to by the acronym PCP—is a potentially life-threatening condition in which fluid builds up in the lungs and causes inflammation.
What is the best way to collect sputum?
A bronchoalveolar lavage is another way to collect sputum. It uses a bronchoscope to collect a sample from the lungs and, according to several sources, is common and useful in diagnosing fungal infections, especially to differentiate between Pneumocystis jirovecii and other fungi.
What does PFT mean in medical terms?
A PFT looks at how much air you breathe in and out, how fast you breathe out, and the amount of oxygen moving from your lungs into your blood.
How many cases of pneumocystis jirovecipneumonia after inflix?
Pneumocystis jirovecipneumonia after infliximab therapy: a review of 84 cases.
Is PCP a clinical suspicion?
The historical difficulties in diagnosing PcP has resulted in many cases being treated on clinical suspicion alone. In a recent 10-year audit of PcP in the UK, reported deaths due to PcP regularly exceeded the number of laboratory confirmed cases. With the advent of modern diagnostic techniques (Real-time PCR and (1-3)-β-d-Glucan (BDG)) this discrepancy should be reconciled to some degree [1]. PcP in HIV-negative patients often presents non-specifically and follows a more fulminant course. Since timely treatment improves prognosis, clinicians should commence antimicrobials based on clinical suspicion whilst awaiting the results of mycological investigations. PcP is associated with the significant morbidity and mortality, but remains relatively uncommon across most at-risk groups (<5%) [3,4,5]. In HIV-positive patients PcP usually presents as a sub-acute progressive deterioration over a period of weeks, whereas in HIV-negative patients an acute presentation over a few days is more typical [7]. PcP severity can be stratified into mild, moderate or severe disease, depending on presenting symptoms, oxygen saturation, and chest radiology (Table 2) [19]. Extra-pulmonary disease is unusual. The classification of disease severity is applicable regardless of the patient’s predisposing underlying condition [19,20]. Symptoms are generally non-specific, typically pneumonia, other symptoms, include fever, non-productive cough, worsening chest pain, shortness of breath (especially on exertion). Low arterial-oxygen tension may lead to respiratory failure, requiring mechanical ventilation and vasopressor, which is a poor prognostic feature.
Is caspofungin effective against PJP?
However, there are a few reports of successful caspofungin administration in PJP. Echinocandins such as caspofungin may be active against Pneumocystis based on their activity against the inclusion of (1-3)beta-D glucan into the fungal cell wall, but clinical data are lacking.
Does PJP respond to antifungal treatment?
Answer. While officially classified as a fungal pneumonia, P jiroveci pneumonia (PJP) does not respond to antifungal treatment. The treatment of choice is TMP-SMX, with second-line agents including pentamidine, dapsone (often in combination with pyrimethamine), or atovaquone.
How is Neisseria gonorrhoeae transmitted?
Neisseria gonorrhoeae is commonly transmitted through the sharing of needles during drug use or by contaminated blood products.
What is the term for yeast cells with buds in a steering wheel?
yeast cells with buds in a "steering wheel" formation Paracoccidioidomycosis begins as a pulmonary disease that spreads to the mucous membranes. It is diagnosed in part by the presence of yeast cell buds in a "steering wheel" formation in microscopic preparations. A South American patient who makes his living as a farm worker sees ...
