Pneumocystose

Abstract

AbstractThe Pneumocystis genus includes some species belonging to Ascomycota phylum. These micromycetes are atypical because they are presently uncultivable, resistant to amphotericin B and azoles but sensitive to sulfonamides and echinocandins. They have a strong pulmonary tropism and are airborne transmitted between host mammals of the same species. Pneumocystis jirovecii (P. jirovecii) is the species infecting humans. It is responsible for severe pneumonia in patients infected with human immunodeficiency virus (HIV). Pneumocystis pneumonia (PCP) remains the most common AIDS defining opportunistic infection in metropolitan France. However, PCP is currently more commonly observed in immunocompromised patients not infected with HIV The symptoms of PCP include the triad, fever, dyspnea and dry cough associated with ground-glass pictures at the chest CT-scan in relation to bilateral alveolar-interstitial pneumonia.The biological diagnosis of PCP is based on the detection of P. jirovecii by microscopy and PCR in lung samples, with broncho-alveolar lavage fluid remaining the reference sample. β-1,3-D-glucan detection in serum is an additional useful diagnostic tool. The sulfamethoxazole-trimethoprim combination is the first-line treatment while pentamidine, atovaquone, dapsone, and echinocandins represent second-line treatments.