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

2. 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

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

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

5. Geography
Worldwide
Sandra

6. 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

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

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

9. Life Cycle
Sandra

10. 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

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

12. 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

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

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

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

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

17. Review
Sandra

18. Bibliography
pages/pneumocystis-carnii.html
pneumonia/overview.html
iiPneumonia(PCP)
pneumocystis-pneumonia-pcp-in-non-hiv-immunocompromised-patients