Abstract

Pneumocystis jirovecii is a widespread fungal colonizer of the human lung. Proliferation of the pathogen in the alveoli is controlled by the immune system in healthy individuals. When the immune system is impaired, pneumocystosis can emerge, resulting in a pulmonary infection. Formerly, the disease occurred mainly in acquired immune deficiency syndrome (AIDS) patients, accompanied by a high mortality. Now it is increasingly seen in patients with immunosuppressive treatment. Traditionally, laboratory diagnosis is based on the microscopic detection of cysts and trophic forms of P. jirovecii in respiratory samples. Quantitative PCR-based methods will revolutionize laboratory diagnosis. However, cutoffs have to be established to discriminate between colonization (clinically irrelevant) and infection. Furthermore, the data on the serological detection of (1→3)-s-D-glucan to diagnose or exclude pneumocystosis is promising.

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