Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- 37 Serious infections caused by typical bacteria
- 38 Tuberculosis
- 39 Disseminated Mycobacterium avium complex infection
- 40 Fungal infections
- 41 Herpesvirus infections
- 42 Pneumocystis carinii pneumonia (PCP)
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
42 - Pneumocystis carinii pneumonia (PCP)
from Part V - Infectious problems in pediatric HIV disease
Published online by Cambridge University Press: 03 February 2010
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- Part II General issues in the care of pediatric HIV patients
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- 37 Serious infections caused by typical bacteria
- 38 Tuberculosis
- 39 Disseminated Mycobacterium avium complex infection
- 40 Fungal infections
- 41 Herpesvirus infections
- 42 Pneumocystis carinii pneumonia (PCP)
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
Summary
Pneumocystis carinii pneumonia (PCP) is the most common AIDS-defining condition and most life-threatening opportunistic infection in children infected with HIV in developed countries. The incidence of PCP has decreased dramatically with the introduction of highly active antiretroviral therapy (HAART) and with routine use of prophylaxis regimens.
Biology and taxonomy
In 1909 and 1910, Chagas and Carini first described Pneumocystis carinii, incorrectly, as the sexual state of Trypanosoma cruzi [1, 2]. The organism was identified as a unique microbe in 1912 in Parisian sewer rats and named after Carini. It was recognized as a human pathogen in 1952 by the Czech parasitologist, Jirovec [3] who causally related the organism to plasma cell pneumonia in 3 to 6-month-old preterm and malnourished infants living in European orphanages after World War II. From that time until the 1980s, PCP was uncommon, occurring primarily in patients who were immunocompromised because of cancer therapy or congenital immune deficiencies [4].
Pneumocystis is a unicellular eukaryotic organism with a nuclear membrane and intracellular organelles. It exists in three morphologic forms: sporozoites, trophozoites, and cysts. Trophozoites (2–5 μm) adhere to alveolar epithelium where they multiply and mature into cysts (5–8 μm). These cysts are round or crescent-shaped thick-walled structures that contain up to 8 sporozoites (1–2 μm) which when released mature to become trophozoites. The cyst and trophozoite forms are found in lung and pleural fluid.
Pneumocystis organisms were initially thought to be a single strain that infected a broad range of hosts.
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- Information
- Textbook of Pediatric HIV Care , pp. 620 - 632Publisher: Cambridge University PressPrint publication year: 2005