Tapparel L, Petignat P-A, Praz G
Département de médecine, CHCVs-Sion.
Rev Med Suisse. 2010 Oct 13;6(266):1922-5.
Pneumocystis jirovecii pneumonia is an opportunistic infection affecting not only HIV patient but also patients with others causes of immunosuppression. The reference method for the diagnostic is the direct visualization of the pathogen in induced sputum or in bronchoalveolar lavage with a low sensibility. Direct immunofluorescence does not increase significantly this sensibility on IS. The PCR has been demonstrated to have 100% sensitivity. This gives rise to the problem of falsely positive results in patients, colonized by P. jiroveci (8,9-26,9%) but suffering from a pneumonia due to another pathogen. Use of quantitative PCR or serum beta-D-glucan, might be helpful to distinguish colonization from infection. This paper reviews the literature on the diagnostic of PCP in non HIV patients.
耶氏肺孢子菌肺炎是一种机会性感染，不仅影响艾滋病患者，也影响其他免疫抑制原因的患者。诊断的参考方法是在诱导痰或支气管肺泡灌洗中直接观察病原体，但敏感性较低。直接免疫荧光法在诱导痰上并不能显著提高这种敏感性。已证明聚合酶链反应（PCR）具有100%的敏感性。这就产生了一个问题，即对于被耶氏肺孢子菌定植（8.9% - 26.9%）但因另一种病原体导致肺炎的患者，会出现假阳性结果。使用定量PCR或血清β - D - 葡聚糖可能有助于区分定植和感染。本文综述了非艾滋病患者中肺孢子菌肺炎诊断的相关文献。
