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Pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis

Accompanying the increased use of biologic and non-biologic antirheumatic agents, patients with RA have been exposed to an increased risk of Pneumocystis jirovecii infection, which causes acute fulminant P. jirovecii pneumonia (PCP). Mortality in this population is higher than in HIV-infected indivi...

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Autores principales: Mori, Shunsuke, Sugimoto, Mineharu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510430/
https://www.ncbi.nlm.nih.gov/pubmed/23001613
http://dx.doi.org/10.1093/rheumatology/kes244
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author Mori, Shunsuke
Sugimoto, Mineharu
author_facet Mori, Shunsuke
Sugimoto, Mineharu
author_sort Mori, Shunsuke
collection PubMed
description Accompanying the increased use of biologic and non-biologic antirheumatic agents, patients with RA have been exposed to an increased risk of Pneumocystis jirovecii infection, which causes acute fulminant P. jirovecii pneumonia (PCP). Mortality in this population is higher than in HIV-infected individuals. Several guidelines and recommendations for HIV-infected individuals are available; however, such guidelines for RA patients remain less clear. Between 2006 and 2008 we encountered a clustering event of P. jirovecii infection among RA outpatients. Through our experience with this outbreak and a review of the recent medical literature regarding asymptomatic colonization and its clinical significance, transmission modes of infection and prophylaxis of PCP, we have learned the following lessons: PCP outbreaks among RA patients can occur through person-to-person transmission in outpatient facilities; asymptomatic carriers serve as reservoirs and sources of infection; and short-term prophylaxis for eradication of P. jirovecii is effective in controlling PCP outbreaks among RA outpatients.
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spelling pubmed-35104302012-11-30 Pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis Mori, Shunsuke Sugimoto, Mineharu Rheumatology (Oxford) Review Accompanying the increased use of biologic and non-biologic antirheumatic agents, patients with RA have been exposed to an increased risk of Pneumocystis jirovecii infection, which causes acute fulminant P. jirovecii pneumonia (PCP). Mortality in this population is higher than in HIV-infected individuals. Several guidelines and recommendations for HIV-infected individuals are available; however, such guidelines for RA patients remain less clear. Between 2006 and 2008 we encountered a clustering event of P. jirovecii infection among RA outpatients. Through our experience with this outbreak and a review of the recent medical literature regarding asymptomatic colonization and its clinical significance, transmission modes of infection and prophylaxis of PCP, we have learned the following lessons: PCP outbreaks among RA patients can occur through person-to-person transmission in outpatient facilities; asymptomatic carriers serve as reservoirs and sources of infection; and short-term prophylaxis for eradication of P. jirovecii is effective in controlling PCP outbreaks among RA outpatients. Oxford University Press 2012-12 2012-09-21 /pmc/articles/PMC3510430/ /pubmed/23001613 http://dx.doi.org/10.1093/rheumatology/kes244 Text en © The Author 2012. Published by Oxford University Press on behalf of the British Society for Rheumatology. http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Mori, Shunsuke
Sugimoto, Mineharu
Pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis
title Pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis
title_full Pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis
title_fullStr Pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis
title_full_unstemmed Pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis
title_short Pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis
title_sort pneumocystis jirovecii infection: an emerging threat to patients with rheumatoid arthritis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510430/
https://www.ncbi.nlm.nih.gov/pubmed/23001613
http://dx.doi.org/10.1093/rheumatology/kes244
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