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Persistent hematogenous dissemination in pulmonary P. jiroveci infection

E Righi1,2, A La Rosa3, A Sartor4

  • 1Infectious Diseases Division, Santa Maria della Misericordia University Hospital, Udine, Italy. elda.righi@libero.it.

Mycopathologia
|April 8, 2019
PubMed

Insights

Pneumocystis jiroveci pneumonia is rare in non-HIV patients. This study documents the first isolation of Pneumocystis jiroveci oocysts from blood in a human patient, suggesting potential hematogenous spread.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Pneumocystis jiroveci pneumonia (PCP) is uncommon in non-HIV individuals.
  • PCP in this population often presents atypically and with greater severity.
  • Extrapulmonary PCP can occur via hematogenous dissemination, but oocysts in blood are undocumented.

Observation:

  • A non-HIV patient presented with bilateral diffuse pulmonary nodules.
  • The patient showed persistent isolation of Pneumocystis jiroveci oocysts in blood samples.
  • P. jiroveci DNA was consistently detected via polymerase chain reaction (PCR).

Findings:

  • This case represents the first documented instance of P. jiroveci oocysts isolated from human blood.
  • The findings suggest that hematogenous dissemination of P. jiroveci may occur in non-HIV patients.
  • Prolonged trimethoprim/sulfamethoxazole treatment was administered.

Implications:

  • This discovery expands the understanding of P. jiroveci dissemination routes.
  • It highlights the importance of considering extrapulmonary P. jiroveci in non-HIV patients.
  • Further research is needed to clarify the clinical significance and diagnostic approaches for disseminated PCP.
Keywords:
Blood oocystsHIV-negative patientPersistent infectionPneumocystis jiroveci

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