Pneumocystic Jirovicii Pneumonia (previously Pneumocystic Carinii Pneumonia) remains an important opportunistic infection in critical care. Improved treatment for HIV has reduced the frequency of PJP due to AIDS, but meanwhile the development of increasingly sophisticated immunosuppressive regimens for other patient populations has increased the incidence of non-HIV PJP. New diagnostic tests are improving our ability to diagnose PJP non-invasively, but these tests also add an additional layer of complexity.
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The IBCC chapter is located here.
- The podcast & comments are below.
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Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
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In the beta-D glucan section of the chapter, it is mentioned that beta D-glucan is present in most fungi except cryptococcus and zygomycetes. However, in the next sentence it is also stated that “This is not specific for PJP, but rather can be seen with a variety of fungal infections (e.g., aspergillus, histoplasma, cryptococcus, or candida).” I am a bit confused as to whether whether cryptococcus present with positive beta D-glucan? Or is it a typo? Thank you.
Hello and thanks for the great chapter which I learned a lot from. One thought on the non invasive diagnostic path though: in my experience a large proportion of hiv+Patients who present with advanced disease and respiratory symptoms have oesophageal candidiasis. If as you mention, colonization with candida can give you a positive beta d glycane, the PPV of the Essay for PJP in this Patient Population would be greatly diminished
Thanks and thanks again for the great podcast