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Pneumocystis jirovecii and microsporidia: An unusual coinfection in HIV patients?

Yaxsier de Armas1, Virginia Capó1, Fernando Jorge Bornay-Linares2

  • 1Pathology Department, Institute of Tropical Medicine "Pedro Kourí," Havana, Cuba.

Medical Mycology
|June 5, 2020
PubMed

Insights

Coinfection with Pneumocystis jirovecii and microsporidia is rare in AIDS patients, found in less than 1% of autopsies. Early diagnosis of these opportunistic infections is crucial for effective treatment and improved patient outcomes.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Immunocompromised Hosts

Background:

  • Pneumocystis jirovecii and microsporidia are opportunistic pathogens frequently seen in AIDS patients.
  • Coinfection with both P. jirovecii and microsporidia is seldom reported, posing diagnostic and therapeutic challenges.

Purpose of the Study:

  • To investigate the prevalence and characteristics of P. jirovecii and microsporidia coinfection in deceased AIDS patients.
  • To highlight the significance of early diagnosis for managing these dual opportunistic infections.

Main Methods:

  • Post-mortem histological examination using Grocott's methenamine silver and Brown Brenn staining.
  • Molecular techniques for accurate identification and characterization of P. jirovecii and microsporidia species.
  • Analysis of 514 autopsied cases from deceased AIDS patients.

Main Results:

  • P. jirovecii and microsporidia were identified in 10.3% and 12.1% of cases, respectively.
  • Coinfection with both pathogens was found in 5 cases (0.97%) out of 514 autopsies.
  • Histological and molecular methods confirmed the presence of both opportunistic infections in coinfected individuals.

Conclusions:

  • Coinfection of P. jirovecii and microsporidia in AIDS patients is a rare but significant finding.
  • Understanding the host-parasite relationship in coinfection is critical for clinical management.
  • Prompt diagnosis and treatment are essential to improve patient outcomes and reduce mortality in coinfected individuals.
Keywords:
PneumocystisAIDSautopsycoinfectionmicrosporidia

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