PDF(Pubmed)
Abstract：
UNASSIGNED: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic fungal infection that is increasingly seen in HIV-negative patients with immune compromise due to other etiologies. We lack comprehensive clinical recommendations for this population.
UNASSIGNED: In non-HIV cases, PJP has a mortality rate of up to 50%, which is unacceptable despite the presence of safe and effective prophylaxis and therapy. Steroid use is one of the most common risk factors for disease development. New data suggests that lower doses of the preferred treatment regimen, TMP-SMX, may be equally effective for treatment while limiting side effects. While commonly used, the benefit of corticosteroids for the treatment of PJP has recently been called into question, with a recent multicenter cohort demonstrating no benefit among solid organ transplant recipients.
UNASSIGNED: A high suspicion of PJP in individuals with pneumonia during immunosuppressant use is crucial. Therapeutic options are evolving to decrease potential side effects while maintaining efficacy in this highly morbid disease.
UNASSIGNED: In non-HIV cases, PJP has a mortality rate of up to 50%, which is unacceptable despite the presence of safe and effective prophylaxis and therapy. Steroid use is one of the most common risk factors for disease development. New data suggests that lower doses of the preferred treatment regimen, TMP-SMX, may be equally effective for treatment while limiting side effects. While commonly used, the benefit of corticosteroids for the treatment of PJP has recently been called into question, with a recent multicenter cohort demonstrating no benefit among solid organ transplant recipients.
UNASSIGNED: A high suspicion of PJP in individuals with pneumonia during immunosuppressant use is crucial. Therapeutic options are evolving to decrease potential side effects while maintaining efficacy in this highly morbid disease.
摘要：
■jirovecii肺孢子菌肺炎（PJP）是一种机会性真菌感染，在HIV阴性患者中由于其他病因而导致免疫受损的情况越来越多。我们缺乏针对该人群的全面临床建议。
■在非HIV病例中，PJP的死亡率高达50％，这是不可接受的，尽管存在安全有效的预防和治疗。类固醇使用是疾病发展的最常见风险因素之一。新数据表明，较低剂量的首选治疗方案，TMP-SMX,可能同样有效的治疗，同时限制副作用。虽然常用,皮质类固醇治疗PJP的益处最近受到质疑，最近的多中心队列显示实体器官移植受者没有获益。
■在使用免疫抑制剂的肺炎患者中，高度怀疑PJP是至关重要的。治疗选择正在发展，以减少潜在的副作用，同时保持这种高度病态疾病的疗效。
■在非HIV病例中，PJP的死亡率高达50％，这是不可接受的，尽管存在安全有效的预防和治疗。类固醇使用是疾病发展的最常见风险因素之一。新数据表明，较低剂量的首选治疗方案，TMP-SMX,可能同样有效的治疗，同时限制副作用。虽然常用,皮质类固醇治疗PJP的益处最近受到质疑，最近的多中心队列显示实体器官移植受者没有获益。
■在使用免疫抑制剂的肺炎患者中，高度怀疑PJP是至关重要的。治疗选择正在发展，以减少潜在的副作用，同时保持这种高度病态疾病的疗效。
