All of the following statements about Pneumocystis Jiroveci are true Except:
Answer is A (Usually associated with CMV infection): Pneumocystis Jiroveci may be associated with CMV infection but it is not usually associated with CMV infection. Pneumocystis Jiroveci is the new nomenclature for human infection with Pneumocystic carini (which is now used for organisms found in rats) Pneumocystis infection in Humans : P. Jiroveci Pneumocystis infection in Rats : P. Carini Pneumocystic Jiroveci disease and immunosupression `Pneumocystis Jiroveci does not cause disease in the absence of immuno supression' Note Pneumocystic Jiroveci may infect immunocompetent hosts but the disease (pneumocvstis pneumonia) occurs only when the host is immunosupressed Most individuals are infected in early childhood But pneumonia occurs in immunocompromised patients only either due to reactivation or new infection. Persons at risk for Pneumocystic disease (Pneumocystosis) Acquired Immunodeficiency Disease (eg AIDS) Patients Recieving Immunosupressive therapy (especially Glucocoicoids) for cancer, organ transplantation etc. Children with primary immunodeficiency diseases Premature malnourished infants (immunodeficient) Pneumocystic Pneumonia : Diagnosis Diagnosis of Pneumocystic Pneumonia is based on specific identification of organism in respiratory specimen with appropriate histological staining Pneumocystis infection is usually diagnosed by sputum examination Sputum samples should always be obtained by induction (with hypeonic saline) Routine sputum specimen is often inadequate (Washington manual of Pulmonary medicine) BAL forms the mainstay of diagnosis for Pneumocvstic Pneumonia If organisms are not seen on induced sputum examination a Bronchoalveolar lavage specimen should be obtained. BAL forms the mainstay of diagnosis for Pneumocystic Pneumonia - Harrisons 16th Pne imocvstic Pneumonia and CMV infection (Pneumocystic Pneumonia' by Wolzer & Cushion 3rd/418) `Several studies have indicated that CMV is a risk factor for Pneumocystis Pneumonia in Renal transplant patients These is however no convincing evidence to show a direct effect of the CMV virion on Pneumocystis' Thus we conclude Pneumocystic may be associated with CMV infection but in a few selected cases and special circumstances like Renal tansplantation. CMV is not usually associated with pneumocystic pneumonia. Pneumocvstis Pneumonia and Pneumatocele Pneumocystic Pneumonia may be associated with pneumotocele formation but Pneumatoceles are not associated in all cases of Pneumocystic pneumonia Pneumatocele: Differential Diagnosis (CT scan of the body by Mathias /362) Post infectious (Staphylococcaldeg and other bacterial infections) Pneumocystic Post traumatic (Laceration ) After treatment of metastasis (rare)
Usually associated with CMV infection
May be associated with Pneumatocele
Usually diagnosed by sputum examination
Causes disease only in the immunocompromised host