Abstract
Pneumocystis jirovecii pneumonia (PJP) is one type of life-threatening pneumonia in immunocompromised patients. PJP development should be considered in not only immunocompromised individuals, but also patients undergoing intensive chemotherapies and immunotherapies, organ transplantation, or corticosteroid treatment. Past studies have described the clinical manifestation of PJP in patients during chemotherapy and reported that PJP affects cancer treatment outcomes. Therefore, PJP could be a potential problem for the management of cancer patients during chemotherapy, and PJP prophylaxis would be important during cancer treatment. This review discusses PJ colonization in outpatients during cancer chemotherapy, as well as in healthy individuals, and provides an update on PJP prophylaxis for cancer patients during chemotherapy.
Highlights
Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection caused by the yeast-like fungus PJ
Two clinical factors need to be considered regarding the onset of this pneumonia; one is the airway environment, such as mucus damage from air pollution, chemical substances associated with cancer chemotherapy, and colonization of bacteria or fungi in the airway during cancer chemotherapy, in which PJ settles, and the other is host immunity against
PJ DNA was detected at a higher rate in healthy smokers (47%) compared with healthy non-smokers (20%), suggesting that smoking may be associated with PJ colonization in airways and air vesicles and may increase the mortality rate of PJP among cancer patients
Summary
Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection caused by the yeast-like fungus PJ. Two clinical factors need to be considered regarding the onset of this pneumonia; one is the airway environment, such as mucus damage from air pollution, chemical substances associated with cancer chemotherapy, and colonization of bacteria or fungi in the airway during cancer chemotherapy, in which PJ settles, and the other is host immunity against. DNA is detectable in sputum or bronchoalveolar lavage specimens, from PJP and immunocompromised patients and from healthy individuals, suggesting that PJ transmission may occur via an airborne route. PJ can colonize airways and pulmonary alveoli of some healthy individuals with latent infection. Mucosal damage and the risks of PJ colonization; Diagnosis of PJP; Host immunity-associated risks of PJP for patients during cancer chemotherapy; Chemoprophylaxis for PJP (first- and second-line) in immunocompromised patients
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