The shift from pulmonary colonization to Pneumocystis pneumonia

Author:

Le Gal Solène12,Bonnet Pierre12,Huguenin Antoine3,Chapelle Célia1,Boulic Pierrick1,Tonnelier Jean-Marie4,Moal Marie-Christine5,Gut-Gobert Christophe6,Barnier Aude6,Nevez Gilles12

Affiliation:

1. Université de Brest, Université d'Angers, GEIHP, Brest, France

2. Laboratory of Parasitology and Mycology, Brest University Hospital, Brest, France

3. EA 7510, ESCAPE, Laboratory of Parasitology and Mycology, Université de Reims Champagne-Ardenne, 51 rue Cognacq Jay, 51092 Reims CEDEX, France

4. Intensive care, Brest University Hospital, Brest, France

5. Transplantation unit and nephrology, Brest University Hospital, Brest, France

6. Pneumology and Internal Medicine, Brest University Hospital, Brest, France

Abstract

Summary Pulmonary specimen pairs from five patients who presented with pulmonary colonization and later developed Pneumocystis Pneumonia (PcP) were retrospectively examined for P. jirovecii genotyping. A match of genotypes in pulmonary specimen pairs of three patients was observed, whereas a partial match and a mismatch were observed in the fourth and fifth patients, respectively. The genotyping results suggest that the colonization state can differ from PcP but can also represent the incubation period of PcP. Clinicians should not systematically rule out the treatment of putative colonized patients and should at least discuss the initiation of prophylaxis on a case-by-case basis.

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,General Medicine

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