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Pneumocystis

carinii
Katrina Kittleson
Steda Lundak
Parasitology 2007

bone marrow. lymph nodes. eyes .Introduction Fungus or Protozoan?? Orphan organism. phylogenic position has not yet been established Opportunistic Parasite Severe pathology in immunodeficient hosts Severely malnourished newborns One of the initial signs of AIDS emergence Lives in interstitial tissue of lungs Rarely disseminates to spleen.

Fungus vs. Protozoan Fungus from nucleic acid and biochemical analysis rRNA homologous to that found in fungi stains with some fungal stains Affinity for Grocott’s methenamine silver stain Produces chitin has ultrastructural characteristics similar to some fungi Protozoan other structures similar to Toxoplasma and Plasmodium is sensitive to a variety of antiprotozoal agents. It’s membrane properties resemble those of amebas Shows surface antigenic variation which occurs in protozoa and has not been established in fungi .

Geographic Distribution Worldwide Most children exposed by the age of 3-4 years Commonly found in the lungs of healthy individuals. but no disease occurs Widespread in mammals .

malnourished children. dogs. owl monkeys. goats. AIDS Patients receiving cytotoxic or immunosupressive drugs for lymphoresticular cancers or transplants Other mammals: rabbits. swine. chimpanzees.Hosts Humans Pneumocystis jiroveci(i) alternate names Pneumocystis carinii hominis Elderly. cats. primary immunodeficiency disorders. horses .

new infection? .Transmission Aerosol droplets Direct contact Congenital infection Household pets Interspecies transmission? Reactivation of latent infection when immunocompromised Or.

Can be spherical or collapsed. .Life Cycle Life cycle is not fully known Asexual and sexual reproduction (CDC) Four general morphological forms in mammals Trophozoite (has amoeboid trophozoite form) Precysts Cysts Sporozoites (intracystic bodies) Cyst (diagnostic form) chitinous membrane and 8 intracystic bodies Pore in cyst wall used for releasing sporozoites.

Life Cycle .

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respiratory failure. cyanosis Death by asphyxia . non productive cough. breathing difficulty on exertion. Pneumocystis pneumonia (PCP) Lung epithelium becomes desquamated alveoli fill with foamy exudate containing parasites Fever.Clinical Presentation Causes Pneumonitis.

immunofluorescence assay. methenamine silver Gram-Weigert stain for cysts ELISA.Diagnosis Clinical symptoms Sputum or bronchial lavage Special staining with toluidine blue. DNA amplification being developed .

Diagnosis .

Pictures Trophozoites in BAL material. Cysts in BAL material .

Treatments Trimethoprim-sulfamethoxazole (TMP-SMZ) Pentamidine isethionate inhalant Treatments can be toxic and patient must be monitored closely Prophylactic treatment if CD4 count is low (<200) HAART regimen to boost immune system function. corticosteroids .

Pneumocystis carinii Infection: Update and Review Questions Relationship with immunosupression Taxonomic classification Morphology Latent infection or new infection? Diagnosis. treatment. prophylaxis Research into a vaccine .

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nih.nlm.org National Library of Medicine http:// www.gov .More information/References Parasitology textbook Discussion article Familydoctor.gov/ Center for Disease Control and Prevention http://www.org Aafp.cdc.