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HIV感染者及非感染者中肺孢子菌肺炎的诊疗进展 张德发.pdf

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HIV感染者及非感染者中肺孢子菌肺炎的诊疗进展 张德发.pdf

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2022 7 28 7 Chin J AIDS STD Jua (PCP) is a well-known opportunistic infection
with well-established management programs. However, PCP is an emerging threat to immunocompromised patients
without HIV infection, such as those receiving novel immunosuppressive therapeutics for malignancy, organ
transplantation, or connective tissue diseases. Clinical manifestations of PCP are different between patients with and
without HIV infections. In patients without HIV infection, PCP rapidly progresses, is challenging to diagnose correctly and
causes severe respiratory failure with a poor prognosis. In addition, high-resolution computed tomography findings are
different between PCP patients with or without HIV infection. These differences in clinical and radiological features are
due to severe or dysregulated inflammatory responses evoked by a relatively small number of Pneumocystis organisms in
patients without HIV infection. In recent years, the usefulness of polymerase chain reaction and serum β-D-glucan assay
for rapid and non-invasive diagnosis of PCP has been revealed. Although corticosteroid adjunctive to anti-Pneumocystis
agents is beneficial in some populations, the optimal dose and duration remain determined. Because a variety of nov