Пневмоцистоз: симптомы, диагностика и лечение

Disseminated: Depends on affected organ
| complications =*Lungs: respiratory failure

Pneumocystosis is generally an infection in the lungs. or spleen. It may also affect skin, kidneys, thyroid, heart, adrenals and gastrointestinal tract.

When the lungs are affected there is usually a dry cough, difficulty breathing and fever, usually present for longer than four weeks. The oxygen saturation is low.

Pneumocystosis occurs predominantly in people with HIV/AIDS. A chest X ray of affected lungs show widespread shadowing in both lungs, with a "bat wing" pattern and ground glass appearance. Giemsa or silver stains can be used to identify the organism, as well as direct immunofluorescence of infected cells. Diagnosis in the eye involves fundoscopy. A biopsy of the retina and choroid layer may be performed. In affected liver, biopsy shows focal areas of necrosis and sinusoidal widening. H&E staining show extracellular frothy pink material. Typical cysts with a solid dark dot can be seen using a Grocott silver stain.

Pneumocystosis may appear similar to pulmonary embolism or adult respiratory distress syndrome. Other infections can present similarly such as tuberculosis, Legionella, and severe flu.

There is no vaccine that prevents pneumocystosis. Trimethoprim/sulfamethoxazole (co trimoxazole) might be prescribed for people at high risk.

Treatment is usually with co trimoxazole. Other options include pentamidine, dapsone and atovaquone.

It is fatal in 10 20% of people with HIV/AIDS. Pneumocystosis in people without HIV/AIDS is frequently diagnosed late and the death rate is therefore higher; 30 50%.

The exact number of people in the world affected is not known. Pneumocystosis affects lungs in around 97% of cases and is often fatal without treatment.

The first cases of pneumocystosis affecting lungs were described in premature infants in Europe following the Second World War. It was then known as plasma cellular interstitial pneumonitis of the newborn. Pneumocystis jirovecii (previously called Pneumocystis carinii) is named for Otto Jírovec, who first described it in 1952.