Initially described as “plasma cell pneumonia”, pulmonary infection with the microorganism Pneumocystis jiroveci (formely known as Pnemocystis carinii) was first identified in malnourished infants (especially those in orphanages) at the conclusion of the Second World War. Today this disease, manifesting as a severe and often fatal pneumonia in immunocompromised patients, is of increasing importance to pediatricians and other specialists around the world.
Pneumocystis jiroveci is an opportunistic unicellular fungal pathogen that is widespread in the environment and thought to enter the body via airborne transmission. It also represents one of the several microorganisms that can cause life-threatening infection in patients with advanced HIV
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When organ transplantation became more pervasive in clinical medicine, it became evident that this type of pneumonia was linked to the immunosuppression used to prevent rejection of the organs.
In 1980s clusters of Pneumocystis pneumonia were observed in previously healthy men, which subsequently prompted a search of underlying cause of immunosuppression and eventually led to the first definition of the acquired immune deficiency syndrome (AIDS). And indeed, it turned out that a majority of individuals who develop Pneumocystis pneumonia have abnormal function and/or number of T lymphocytes.
Today, this type of pneumonia is still ubiquitous AIDS-defining diagnosis in North America, Europe and Asia, albeit it is mostly restricted to patients unaware of their HIV status at presentations, as well as to those intolerant or non-compliant in regards to antiretroviral
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Nevertheless, individuals with hampered immunity, and most notably those with CD4+ T cells (which play a pivotal role in mediating adaptive immune response to a plethora of pathogens) below 200 per μl of blood are considered at risk for the development of Pneumocystis pneumonia.
The research has shown that immunocompetent hosts are potential reservoirs of the fungus in population, as they can transfer it from one person to another when the distance is sufficiently close. Animal studies have demonstrated that even close-contact periods as short as one day can result in transferring Pneumocystis jiroveci from donors to immunocompetent recipients.
Except immunosuppression, other important risk factors for Pneumocystis colonization and Pneumocystis pneumonia are pulmonary disorders and infection with cytomegalovirus (CMV). The latter is due to the suppression of both helper T cells and antigen presenting cells by the virus, which inevitably alters host immune
Pneumonia is an acute infection of the lungs, it can be caused by a variety of organisms entering the body – including bacteria, viruses or fungi. The infection causes an inflammation of the alveoli (air sacs) of the lungs and may result in the alveoli filling with fluid or other purulent material (Mayo Clinic, 2016). An accumulation of fluid within alveoli and portions of the lungs, can reduce the ability of the lungs to allow for oxygen diffusion across the alveoli walls. If oxygen saturation is low, it can cause the body’s cells to not work effectively. Therefore, the risk of the infection spreading through the body is increased – it is due to this reason, that pneumonia can be life-threatening (American Lung Foundation, 2016). Pneumonia
Thirty pounds of lost weight, fever and a lung infection, what is it? The mystery shrouded the world in disbelief of this invincible new illness. Who was getting it? Who knew about it? What is our government going to do? What is a question posed time after time, but the answer rarely came. Early in the 1981 a physician saw his first case. The patient thin, frail, lungs infected, SOB, and pneumonia. Studies on the individual continued until they saw pneumo systis pneumonia, a rare and fatal disease only seen in damaged immune systems. To the doctors surprise they may have found an important first step in discovering what this thing actually was. A similar case on June 5th 1981 in San Fransisco, California was reported. The symptoms of the young 22 year old man was becoming more apparent what the new illness looks like from the outside. The frail wasting body which had lesions, opportunistic conditions dropping the immunity, attacks on the brain, and with it relentless headaches. The way it was described in the NPR movie ,"The Age of AIDs" was, "Young men were curling up to die like 80yr old men." These men contracted an immune attacking virus which attacks the T fighter cells and rendering them useless after being overpowered and eventually masked to be ignored.
This paper explores Pneumonia and the respiratory disease process associated with bacterial and viral pathogens most commonly located in the lung. The paper examines the process, symptoms and treatments most commonly viewed in patient cases of Pneumonia. My goal is to educate the reader and to warn of the
The Acquired Immune Deficiency Syndrome denotes a spectrum of conditions that are caused by the HIV virus. Infection with this disease does not result in the instant occurrence of the related signs and symptoms. However, an individual is likely to experience flu-like symptoms after he or she is infected with it. Eventually, the person experiences a prolonged period of apparent health with no visible signs. On progression, the infection adversely interferes with the immune system of the individual. The weakening of the body’s defense system increases the risk of recurrence of common infections and opportunistic illnesses that
In 1981, mysterious cases of opportunistic infections began appearing in clusters (“Timeline”). An opportunistic infection is an unusual infection that appears in people with a weakened immune system (Ojikutu). One disease, pneumocystis carinii pneumonia, surfaced in five gay men living in Los Angeles. Another disease, a rare cancer called Kaposi’s sarcoma appeared in patients in both New York and Los Angeles. When doctors at the time realized this, they noticed obvious similarities. The patients were separated geographically, they were only located in two cities. They were also all gay men, that were previously healthy (Ojikutu). Doctors were also finding that whatever they’re patients had was highly fatal. This mysterious disease was first called GRID, Gay-Related Immune Deficiency. Symptoms began lethargy, diarrhea, weight loss, sweats, rash, and swollen lymph nodes. Initial stages resembled the common flu
Pneumonia is described in Tabers cyclopedia medical dictionary, “as inflammation of the lungs, usually due to an infection with bacteria, viruses, or other pathogenic organisms” (p.1833)
In the clinical setting it is found that when there is a bacterial infection that there is a sudden and rapid signs of illness in a patient. There will be dyspnea, hemoptysis, lethargic,
Pneumonia is an inflammation of the lung which results into an excess of fluid or pus accumulating into the alveoli of the lung. Pneumonia impairs gas exchange which leads to hypoxemia and is acquire by inhaling a contagious organism or an irritating agent. (Ignatavicius & Workman, 2013). Fungal, bacteria and viruses are the most common organisms that can be inhale. Pneumonia could be community-acquired or health care associated. Community –acquired pneumonia (CAP) occurs out of a healthcare facility while health care associated pneumonia (HAP) is acquired in a healthcare facility. HAP are more resistant to antibiotic and patients on ventilators and those receiving kidney dialysis have a higher risk factor. Infants, children and the elderly also have a higher risk of acquiring pneumonia due to their immune system inability to fight the virus. Pneumonia can also be classified as aspiration pneumonia if it arises by inhaling saliva, vomit, food or drink into the lungs. Patients with abnormal gag reflex, dysphagia, brain injury, and are abusing drug or alcohol have a higher risk of aspiration pneumonia (Mayo Clinic, 2013). In the case of patient E.O., this patient had rhonchi in the lower lobe and the upper lobe sound was coarse and diminished. Signs and symptoms of pneumonia include difficulty breathing, chest pain, wheezing, fever, headache, chills, cough, confusion, pain in muscle or
Pneumococcal disease is an infection caused by Streptococcus pneumonia and is spread through coughing, sneezing and close contact with others. Individuals can develop severe infections from these bacteria such as pneumonia, meningitis, and bacteremia as well as less severe infections, such as ear infections and sinus infections. However, obtaining the pneumococcal vaccine is the best way to prevent severe disease and its spread. Currently, Pneumovax (PPSV23) and Prevnar 13 (PCV13) are the two types of pneumococcal vaccines approved
Pneumococcal and influenza vaccination are among one of the measures that can reduce the risk of otitis media (4). The major aim of introduction of vaccine in immunization program is to prevent diseases caused by Streptococcus pneumoniae. This is because the effectiveness in the use of antibiotic and other drugs was reduced due to drug resistance strains. There are two types of vaccine recommended for effective prevention of pneumococcal diseases. These vaccines are pneumococcal conjugate and pneumococcal polysaccharide vaccine. Pneumococcal conjugate vaccine is approved for three classes of individuals: children younger than 2 years, children > 2 years to 64 years with medical indication and all adults 65 years and older.
In response to these comments, it was then that the FDA added three additional pathogens to the list of qualifying pathogens: Coccidiodes species, Cryptococcus species, and Helicobacter pylori. Coccidiosis species, Cryptococcus species, and Helicobacter pylori. Coccidiosis is a disease caused by fungi from the genes of Cryptococcus that affect living organisms such as humans and animals. Living organisms usually contract this by inhaling the fungi, thus resulting in lung infection that can travel to the brain causing further harm for the organism. Two individuals were first identified with the fungus between 1894 and 1895. The Cryptococci’s can be found worldwide. The main way that disease is spread is also through inhalation with the particular fungus that happens to be associated with several species of bird, particularly old pigeon waste and bat guano.
Streptococcus pneumoniae is found worldwide. The common host is the human body, in which it often does not cause disease but at other times it can cause diseses in particular, pneumonia. It also causes otitis media, bacteremia, meningitis, peritonitis, and sinusitis. The route by which this organism is spread is from human to human in the form of aerosol droplets. When inside the host the organism’s primary site of pneumococcal colonization is the nasopharynx. From this site it can aspire to the lungs, eventually spread to the blood and traverse the blood-brain barrier to the meninges, once inside the blood it can cause infections throughout the body. Symptoms of the disease include sudden
Pneumonia is an illness of the lower respiratory tract in which the lungs become inflamed and congested and alveolar spaces are filled with fluid and cells-polymorphs and lymphocytes (Mandell L.A). It is an inflammatory condition of the lung and it is one of the most serious infections, causing two million deaths annually among the young and elderly. Pneumonia is the largest killer, accounting for 28% to 34% of all child deaths below five years of age in low-income countries and is an important cause of mortality in the elderly in high-income countries (Suárez).
The clinical manifestations of pneumonia will be different according to the causative organism and the patient’s underlying conditions and/or comorbidities (Smeltzer, et al). Some of the manifestations are
This is a case of a 74 year old woman who was diagnosed with Community Acquired Pneumonia.