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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.
Abstract:
PJP (Pneumocystis jirovecii) is a fungal agent by taxonomy. Ones considered a protozoan, it is now recognized as fungi based on ribosomal RNA and other gene sequence homologies, the composition of their cell walls, and structure of key enzymes. This organism generally affects immunocompromised hosts with a CD4 count <200 or <15%.Review of literature does support a rare occurrence of PJP infections in immunocompetent hosts.PJP can occur at normal CD 4 levels.
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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