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Updated: Jul 20, 2026

Microbiological Rapid On-Site Evaluation for Pulmonary Infectious Diseases
Published on: March 1, 2024
[Pneumocystis jirovecii pneumonia: an old disease with a new name]
Raimonda Matulionyte1, Arvydas Ambrozaitis, Rasute Paulauskiene
1Clinic of Infectious Diseases and Microbiology, Vilnius University, Lithuania. raimonda@infek.elnet.lt
Abstract:
Pneumocystis jirovecii pneumonia has historically been one of the most common opportunistic pneumonias and life-threatening infectious complications in HIV-infected patients. After the introduction of combination antiretroviral therapy, the incidence of Pneumocystis pneumonia and other opportunistic infections has decreased dramatically. Nowadays Pneumocystis pneumonia still occurs in patients unaware of their HIV status, in those not receiving combination antiretroviral therapy, or in those in whom it is ineffective due to resistance. Age factor is the diagnosis delaying one: patients aged more than 50 years are diagnosed with AIDS later than younger persons. Pneumocystis was thought to be a species of protozoa. Over the last 20 years, Pneumocystis has been shown to be a fungus, to be genetically diverse, host species specific, to colonize individuals with minor immunosuppression, and to cause clinical disease by "new" infection in addition to reactivation of latent childhood-acquired infection. Recently, the microorganism Pneumocystis carinii causing disease in humans has been renamed to Pneumocystis jirovecii. This article presents a clinical case of late diagnosis of Pneumocystis jirovecii pneumonia in a 62-year-old patient unaware of her HIV status and a review of literature reflecting epidemiological issues of Pneumocystis jirovecii and latest discoveries related to Pneumocystis as well as the rationale for renaming it.
Insights
Pneumocystis jirovecii pneumonia (PJP) remains a threat for undiagnosed or untreated HIV patients, especially those over 50. This fungus, formerly a protozoa, causes severe pneumonia, highlighting the need for timely diagnosis and treatment.
Area of Science:
- Mycology and Infectious Diseases
- Immunology
- Clinical Medicine
Background:
- Pneumocystis jirovecii pneumonia (PJP) is a significant opportunistic infection in HIV-infected individuals.
- Combination antiretroviral therapy has drastically reduced PJP incidence but has not eliminated it.
- PJP still affects patients unaware of their HIV status, those not on therapy, or with resistant infections.
Observation:
- A clinical case of PJP is presented in a 62-year-old patient with undiagnosed HIV.
- Older adults (>50 years) are often diagnosed with AIDS later, delaying PJP diagnosis.
- Pneumocystis has been reclassified from protozoa to fungus, with genetic diversity and host specificity.
Findings:
- Pneumocystis jirovecii, the causative agent of PJP in humans, was previously known as Pneumocystis carinii.
- The article reviews epidemiological data and recent discoveries concerning Pneumocystis.
- The rationale for renaming Pneumocystis carinii to Pneumocystis jirovecii is discussed.
Implications:
- Timely HIV diagnosis and treatment are crucial for preventing PJP, even in older populations.
- Understanding Pneumocystis as a fungus with diverse characteristics is vital for diagnostics and therapeutics.
- Late diagnosis of PJP in HIV-unaware individuals underscores the importance of broader screening and awareness programs.
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