Presented by: Samantha Todd & Sandra Thorbus Pneumocystis carinii Presented by: Samantha Todd & Sandra Thorbus

Pneumocystis carinii vs. jirovecii Both Pneumocystis carinii and Pneumocystis jirovecii (yee row vet zee) currently refer to the same organism. P. jirovecii is the organism isolated from humans, while P. carinii is found in rats. Not a protozoan, but a fungus. Sami

Hosts Definitive Host: Humans, other mammals. Intermediate Host: None Sandra

Prevalence AIDS/HIV patients Immunosuppressed individuals Organ transplant recipients Chemotherapy patients Premature, malnourished infants Most healthy children have been exposed by age 5 Sami

Geography Worldwide Sandra

Three Morphological Forms All three forms are found in the lungs 1. Precyst Oval shaped Few filopodia Cell wall thickening Increase in number of nuclei from one to four Sami

Three Morphological Forms 1. Cyst -Mature cysts are spherical, have a thick chitinous membrane and eight intracystic bodies (young trophozoites) Sami

Three Morphological Forms 3. Trophozoite Filopodia form pockets in interstitial cells Most abundant during infection (9:1) Sami

Life Cycle Sandra

Life Cycle Inhalation of infective respiratory droplets Makes its way inside the respiratory tract, settles into alveolar spaces and replicates: Asexual Reproduction 1. Trophozoite reproduction Sexual Reproduction 1. Conjugation 2. Formation of Precyst 3. Formation of early cyst 4. Maturation and Excystment Life cycle repeats Sandra

Transmission Found in environment, lungs & upper respiratory tract of humans and animals Spread by inhalation of infected respiratory droplets Sandra

Symptoms Causes Pneumocystis Pneumonia (PCP) Fever Cough Shortness of breath Cyanosis Non-productive cough Chest pain Malaise Sami Symptoms develop more slowly in those with AIDS and tend to be less severe

Diagnosis Sputum examination Lung biopsy Bronchial lavage Blood gas test Chest X-ray Mortality rate is 100% in untreated patients. Sami

Cysts of Pneumocystis carinii in smear from bronchoalveolar lavage. Sami Cysts of Pneumocystis carinii in smear from bronchoalveolar lavage.

Treatment Trimethoprin-sulfamethoxazole (TMP/SMX, Bactrim) Intravenous or oral administration Alternative Treatments include: Pentamidine Atovaquone Combination of Trimethoprin and Dapsone Sandra

Prevention Primary PCP prophylaxis (preventative antibiotic treatment before the onset of disease) Reduces occurrence of PCP by 90% Sami

Review http://www.youtube.com/watch?v=cuZb539SaaY Sandra

Bibliography http://www.pathologyimagesinc.com/emhandbook/opport-infections-section/inf-agents- pages/pneumocystis-carnii.html http://microbewiki.kenyon.edu/index.php/Pneumocystis_carinii http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/17278.jpg http://health.nytimes.com/health/guides/disease/pneumocystis-carinii- pneumonia/overview.html http://pathmicro.med.sc.edu/mycology/opportunistic.htm http://www.healthscout.com/ency/68/558/main.html#PreventionofPneumocystisCarin iiPneumonia(PCP) http://dpd.cdc.gov/dpdx/html/Pneumocystis.htm http://summaries.cochrane.org/CD005590/antibiotic-treatment-for-the-prevention-of- pneumocystis-pneumonia-pcp-in-non-hiv-immunocompromised-patients