• Pediatric Infection and Vaccine
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• 제4권1호
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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.

• 대한수의학회지
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• 제47권3호
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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.

• Clinical and Experimental Pediatrics
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• 제59권6호
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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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• 제83권2호
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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.

• Pediatric Infection and Vaccine
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• 제12권1호
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• pp.95-99
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• 2005

주폐포자충 폐렴은 면역 기능이 억제된 환자군에서 발병률이 높은 감염성 질환으로 특히, 후천성 면역 결핍증이나 백혈병 등의 혈액 종양 환자군, 심한 영양 결핍 환자군, 장기 이식 환자군, 고용량의 부신 피질 호르몬 사용 환자군 등이 고위험군으로 알려져 있으며, 일차성 면역 결핍증에 이환된 환아에서 주폐포자충 폐렴의 증례가 보고되어 있다. 저자들은 상기 위험군에는 속하지 않으나, 10여일 정도의 수유부진 후 빈호흡을 보인 영아에서 흉부 방사선 소견상, 폐양측에 간질성 침윤이 관찰되었고 기관지내 삽관으로 흡인한 객담의 Gomori-methenamine silver 염색 검사상 주폐포자충이 검출되어 주폐포자충 폐렴으로 확진 후 TMP-SMX 14일 투여로 호전을 보인 예를 경험하여 보고하는 바이다.

• The Korean Journal of Medicine
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• 제93권6호
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• pp.571-574
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• 2018

니볼루맙을 사용하는 도중 폐렴이 발생할 수 있고, 폐렴이 의심되면 치료하기 이전에 바이러스를 포함한 감염 여부와 림프관성 암의 진행 상태 및 울혈성 심장 기능 상실 여부 등의 감별이 필요하며 폐렴의 등급과 중증도를 평가하여 스테로이드를 경험적으로 쓰는 것이 중요하다. 본 증례에서는 감염을 배제하기 위하여 기관지 폐포세척을 시행한 후 폐포자충 폐렴이 진단된 사례로 드물기는 하지만 페포자충 폐렴의 감별이 필요함을 보여주어 증례로 보고하는 바이다.

• Parasites, Hosts and Diseases
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• 제30권3호
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• pp.219-226
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• 1992

This study was performed to observe the therapeutic effects of interferon-gamma ($IFN-{\gamma}$) and gamma-globulin (${\gamma}-globulin$) in experimental Pneumocystis carinii pneumonia of immune suppressed mice. After 9 weeks, trimethoprim-sulfamethoxaBole(TMP-SMZ; 10~50 mg/mouse/day), mouse $IFN-{\gamma}(5{\times}10^4$ units/mouse/day) and mouse ${\gamma}-globulin$(20 mg/mouse/day) were administered to the mice for 3 weeks by the experimental group. The therapeutic efficacy was evaluated by body weights, histopatholo단ic and electron microscopic findings of the lungs, and number of p. carinii cysts by Gomori's methenamine silver stain. Body weights of the mice were significantly increased in the group of combination therapy of TMP-SMZ with $IFN-{\gamma}{\;}or{\;}{\gamma}-globulin$, and in the group of TMP- SMZ treatment(p<0.05), however, little effect was found in the group of T-globulin alone. Histopathologic 6ndings of p. carinii pneumonia were much improved in the group of combination therapy of TMP-SMZ with $IFN-{\gamma}$. Treatment with either TMP-SMZ or $IFN-{\gamma}$ significantly reduced the number of cysts in the p. carinii pneumonia, but {\gamma}-globulin alone was ineffective. In electron microscopic findings of p. carinii pneumonia, the number of trophozoites and cysts were reduced by treatment with either TMP-SMZ or $IFN-{\gamma}$, and most of the cysts were empty or containing one or two intracystic bodies. The present results suggested, that combination therapy of TMP-SMZ with $IFN-{\gamma}$ had synergistic effects in treatment of P carinii pneumonia in experi- mental mice.

• Tuberculosis and Respiratory Diseases
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• 제57권4호
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• pp.372-376
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• 2004

저자들은 면역 억제제인 스테로이드를 사용하던 환자에게서 주폐포자충에 의한 폐렴과 함께 미만성 폐출혈이 발생한 환자 1예를 경험하였기에 보고하는 바이다.

• 대한영상의학회지
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• 제83권1호
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• pp.218-223
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• 2022

폐포자충 폐렴의 전형적인 전산화단층촬영 소견은 양측 폐에 미만성 혹은 다발성의 간유리 음영으로 잘 알려져 있지만, 드물게 다발성 폐 결절 형태로 나타날 수도 있다. 본 저자들은 다발성 골수종 치료로 인해 면역력이 저하된 환자의 양측 폐에 생긴 광범위한 간유리음영 및 이와 동반된 다발성 괴사성 늑막하 결절들이 경피적 폐생검을 통해 육아종성 폐포자충 폐렴으로 확진된 증례를 보고한다.

• Pediatric Infection and Vaccine
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• 제31권1호
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• pp.130-135
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• 2024

인체면역결핍바이러스 감염자의 페포자충폐렴 치료에 있어 보조적 스테로이드 치료의 효용성은 잘 알려진데 반해, 비인체면역결핍바이러스 면역저하자에서의 페포자충폐렴 치료에 있어서의 보조적 스테로이드 치료의 효용성은 논란의 여지가 있다. 본 연구자들은 비인체면역결핍바이러스 면역저하자인 중증복합면역결핍증 영아에서 이환된 중증페포자충폐렴를 치료하던 중 면역재구성염증증후군 유사현상을 관찰하였으며, 보조적 스테로이드 치료에 잘 반응하였기에 이를 보고하는 바이다.