Recent advances in the diagnosis of Pneumocystis jirovecii pneumonia in HIV-infected adults

Sadatomo Tasaka, Hitoshi Tokuda

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Introduction: Pneumocystis jirovecii pneumonia (PCP) is one of the most common opportunistic infections in HIV-infected adults. Although the microscopic demonstration of the organisms in respiratory specimens is still the golden standard of its diagnosis, recent advances in the diagnostic tools have been changing the situation. Areas covered: Colonization of Pneumocystis is highly prevalent among the general population and could be associated with the transmission and development of PCP in immunocompromised individuals. Nested or conventional polymerase chain reaction (PCR) has a high sensitivity, detecting Pneumocystis DNA in induced sputum or oropharyngeal wash, but often produces false positives. Although quantitative real-time PCR is promising for discriminating colonization from PCP, the targeted DNA sequences and the cut-off values remain to be standardized. Serum β-D-glucan is useful as an adjunctive tool for the diagnosis of PCP. High-resolution computed tomography, which typically shows diffuse ground-glass opacities, is informative for evaluation of immunocompromised patients with suspected PCP and normal chest radiography. Expert opinion: Although these new tools have been making the diagnosis of PCP less invasive and more accurate, any one of them can not make a definitive diagnosis by itself. The diagnostic criteria based on the combination of the testing ought to be established.

Original languageEnglish
Pages (from-to)85-97
Number of pages13
JournalExpert Opinion on Medical Diagnostics
Volume7
Issue number1
DOIs
Publication statusPublished - 2013

Fingerprint

Pneumocystis carinii
Pneumocystis Pneumonia
HIV
Polymerase chain reaction
Pneumocystis
Radiography
DNA sequences
Opacity
Tomography
DNA
Demonstrations
Opportunistic Infections
Expert Testimony
Immunocompromised Host
Sputum
Glass
Real-Time Polymerase Chain Reaction
Testing
Thorax
Polymerase Chain Reaction

Keywords

  • Acquired immunodeficiency syndrome
  • High-resolution computed tomography
  • Pneumocystis pneumonia
  • Polymerase chain reaction
  • β-D-glucan

ASJC Scopus subject areas

  • Biomedical Engineering
  • Medicine(all)
  • Biochemistry, medical
  • Molecular Medicine

Cite this

Recent advances in the diagnosis of Pneumocystis jirovecii pneumonia in HIV-infected adults. / Tasaka, Sadatomo; Tokuda, Hitoshi.

In: Expert Opinion on Medical Diagnostics, Vol. 7, No. 1, 2013, p. 85-97.

Research output: Contribution to journalArticle

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