PJP granuloma in an Immune competent host: Case report and literature review

Chandra S Pingili1,2, Vel Sivapalan1,2

  • 1Columbia University medical center, The Affiliation at Harlem hospital, New York, USA.

Idcases
|September 1, 2017
PubMed

Insights

Pneumocystis jirovecii pneumonia (PJP) is a fungal infection typically seen in immunocompromised individuals. However, rare cases of PJP can occur even in those with normal immune function and CD4 levels.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Immunology

Background:

  • Pneumocystis jirovecii (PJP) is taxonomically classified as fungi, distinct from its historical protozoan classification.
  • Fungal classification is supported by genetic sequencing, cell wall composition, and enzyme structures.
  • PJP predominantly affects immunocompromised individuals, particularly those with CD4 counts below 200 cells/µL or 15%.

Purpose of the Study:

  • To review the literature regarding Pneumocystis jirovecii pneumonia (PJP) occurrence.
  • To investigate the possibility of PJP in hosts beyond the typically immunocompromised.

Main Methods:

  • Literature review of documented PJP cases.
  • Analysis of host immune status, specifically CD4 counts, in relation to PJP infection.

Main Results:

  • PJP is most commonly diagnosed in immunocompromised patients.
  • The literature supports rare instances of PJP infections in immunocompetent individuals.
  • PJP has been observed in patients with normal CD4+ T cell counts.

Conclusions:

  • While PJP is strongly associated with immunodeficiency, its occurrence is not strictly limited to this population.
  • Clinicians should consider PJP in differential diagnoses even in immunocompetent patients presenting with relevant symptoms.
  • Further research may elucidate the mechanisms behind PJP in immunocompetent hosts.

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