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[Pneumocystis jirovecii pneumonia in patients with autoimmune diseases]

S Blaas1

  • 1Zentrum für Pneumologie, Klinik Donaustauf, Ludwigstraße 68, 93093, Donaustauf, Deutschland. stefan.blaas@klinik.uni-regensburg.de.

Zeitschrift Fur Rheumatologie
|October 29, 2017
PubMed

Insights

Pneumocystis pneumonia is rising in autoimmune patients due to immunosuppression. Trimethoprim-sulfamethoxazole is key for treating and preventing this lung infection.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Pulmonology

Background:

  • Pneumocystis jirovecii pneumonia (PJP) is increasingly prevalent in patients with autoimmune disorders undergoing intensive immunosuppressive therapy.
  • Humans are the primary reservoir for PJP, with airborne transmission likely causing new infections.
  • Key symptoms include cough, low-grade fever, and shortness of breath on exertion.

Purpose of the Study:

  • To summarize the current understanding of Pneumocystis jirovecii pneumonia in autoimmune patients.
  • To highlight diagnostic and therapeutic strategies for PJP in this population.
  • To discuss the role of prophylaxis in immunocompromised individuals.

Main Methods:

  • Review of current literature on PJP in autoimmune disorders.
  • Analysis of diagnostic methods including imaging (high-resolution CT) and pathogen detection (staining, molecular methods).
  • Evaluation of treatment and prophylaxis strategies, focusing on trimethoprim-sulfamethoxazole (TMP-SMX) and corticosteroids.

Main Results:

  • Diagnosis relies on imaging and confirmed pathogen detection.
  • Trimethoprim-sulfamethoxazole (TMP-SMX) is the primary treatment.
  • Evidence for adjuvant corticosteroid benefit in rheumatological PJP is limited.
  • Primary prophylaxis with TMP-SMX is recommended for high-risk patients.

Conclusions:

  • PJP is a significant concern in immunosuppressed autoimmune patients.
  • Prompt diagnosis and appropriate treatment with TMP-SMX are crucial.
  • Prophylaxis with TMP-SMX is essential for preventing PJP in high-risk individuals.
Keywords:
DiagnosticsEpidemiologyImmunosuppressionPreventionTherapy

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