The shift from pulmonary colonization to Pneumocystis pneumonia

Med Mycol. 2021 May 4;59(5):510-513. doi: 10.1093/mmy/myaa107.

Abstract

Pulmonary specimen pairs from five patients who presented with pulmonary colonization and later developed Pneumocystis Pneumonia (PcP) were retrospectively examined for P. jirovecii genotyping. A match of genotypes in pulmonary specimen pairs of three patients was observed, whereas a partial match and a mismatch were observed in the fourth and fifth patients, respectively. The genotyping results suggest that the colonization state can differ from PcP but can also represent the incubation period of PcP. Clinicians should not systematically rule out the treatment of putative colonized patients and should at least discuss the initiation of prophylaxis on a case-by-case basis.

Keywords: PcP; Pneumocystis jirovecii; genotypes; incubation; pulmonary colonization.

Plain language summary

The results suggest that clinicians should not systematically rule out the treatment of putative patients colonized by Pneumocystis jirovecii and should at least discuss prophylaxis initiation on a case-by-case basis.

MeSH terms

  • Aged
  • Carrier State / diagnosis*
  • Carrier State / microbiology*
  • DNA, Fungal
  • Diagnostic Errors / prevention & control*
  • Female
  • Genotype
  • Genotyping Techniques
  • Humans
  • Lung / microbiology*
  • Male
  • Middle Aged
  • Pneumocystis carinii / classification
  • Pneumocystis carinii / genetics*
  • Pneumocystis carinii / isolation & purification
  • Pneumonia, Pneumocystis / diagnosis*
  • Pneumonia, Pneumocystis / microbiology*
  • Polymerase Chain Reaction
  • Retrospective Studies
  • Risk Factors

Substances

  • DNA, Fungal