Update on pulmonary Pneumocystis jirovecii infection in non-HIV patients

Med Mal Infect. 2014 May;44(5):185-98. doi: 10.1016/j.medmal.2014.01.007. Epub 2014 Mar 11.


Pneumocystis jirovecii is the only fungus of its kind to be pathogenic in humans. It is primarily responsible for pneumonia (PJP). The key to understanding immune defences has focused on T-cells, mainly because of the HIV infection epidemic. Patients presenting with PJP all have a CD4 count below 200/mm(3). The introduction of systematic primary prophylaxis and the use of new anti-retroviral drugs have significantly reduced the incidence of this disease in the HIV-infected population, mainly in developed countries. The increasingly frequent use of corticosteroids, chemotherapy, and other immunosuppressive drugs has led to an outbreak of PJP in patients not infected by HIV. These patients presenting with PJP have more rapid and severe symptoms, sometimes atypical, leading to delay the initiation of a specific anti-infective therapy, sometimes a cause of death. However, the contribution of new diagnostic tools and a better understanding of patients at risk should improve their survival.

Keywords: Immunodepression; Immunodépression; Pneumocystis jirovecii; Pneumonia; Pneumopathie.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Connective Tissue Diseases / complications
  • Connective Tissue Diseases / drug therapy
  • Drug Therapy, Combination
  • Early Diagnosis
  • HIV Seronegativity
  • Humans
  • Immunocompromised Host
  • Immunologic Deficiency Syndromes / complications
  • Immunologic Factors / adverse effects
  • Immunosuppressive Agents / adverse effects
  • Neoplasms / complications
  • Neoplasms / drug therapy
  • Organ Transplantation
  • Pneumocystis Infections / diagnosis
  • Pneumocystis Infections / drug therapy
  • Pneumocystis Infections / epidemiology*
  • Pneumocystis Infections / etiology
  • Pneumocystis Infections / prevention & control
  • Pneumocystis carinii* / drug effects
  • Pneumocystis carinii* / isolation & purification
  • Pneumonia, Pneumocystis / diagnostic imaging
  • Pneumonia, Pneumocystis / epidemiology
  • Pneumonia, Pneumocystis / etiology
  • Polymerase Chain Reaction / methods
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prognosis
  • Radiography
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
  • beta-Glucans / blood


  • Adrenal Cortex Hormones
  • Antineoplastic Agents
  • Immunologic Factors
  • Immunosuppressive Agents
  • beta-Glucans
  • Trimethoprim, Sulfamethoxazole Drug Combination