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J. Fungi 2016, 2(2), 16; doi:10.3390/jof2020016

Low Titer Pneumocystis jirovecii Infections: More than Just Colonization?

1
Lungenklinik Merheim, Kliniken der Stadt Köln gGmbH, Universität Witten-Herdecke, Alfred-Herrhausen-Straße 50, Witten 58448, Germany
2
Institut für Pathologie, Kliniken der Stadt Köln gGmbH, Klinikum der Privaten Universität Witten/Herdecke mit Sitz in Köln, Ostmerheimer Str. 200, Köln/Cologne D-51109, Germany
Present Address: Malteserkrankenhaus St. Hildegardis, Köln D-50935; Germany.
*
Author to whom correspondence should be addressed.
Academic Editor: David S. Perlin
Received: 15 March 2016 / Revised: 29 April 2016 / Accepted: 26 May 2016 / Published: 28 May 2016
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Abstract

Non-pneumonia Pneumocystis jirovecii colonization is thought to occur frequently in immunocompetent individuals. The aim was to analyze if P. jirovecii low-titer detections have more impact than just colonization. From our total cohort of patients for which P. jirovecii testing by qPCR was requested, we selected exclusively those that were fully immunocompetent. Patients were defined as fully immunocompetent if they did not receive immunosuppressive therapy, displayed regular antibody titers, and did not suffer from acquired, inherited or autoimmune diseases. Only those patients with complete medical records available were included. A retrospective analysis identified patients with P. jirovecii colonization and successful antibiotic therapy in response to laboratory pathogen detection. We identified 30 fully immunocompetent patients with P. jirovecii colonization suspected to suffer from infection with the pathogen, but with milder symptoms than pneumonia. All patients were successfully treated with cotrimoxazole against P. jirovecii and resolved from chronic cough and recurrent pulmonary infections. The fact that all patients displayed recovery from their clinical symptoms gives raise to the hypothesis that P. jirovecii infections may also occur in immunocompetent patients but with milder symptoms. View Full-Text
Keywords: PCP; Pneumocystis jirovecii; pneumonia; colonization; chronic cough; successful recovery; chronic infection PCP; Pneumocystis jirovecii; pneumonia; colonization; chronic cough; successful recovery; chronic infection
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Prickartz, A.; Lüsebrink, J.; Khalfaoui, S.; Schildgen, O.; Schildgen, V.; Windisch, W.; Brockmann, M. Low Titer Pneumocystis jirovecii Infections: More than Just Colonization? J. Fungi 2016, 2, 16.

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