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Clinical Microbiology Reviews, October 2004, p. 770-782, Vol. 17, No. 4
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.4.770-782.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Prevention of Infection Due to Pneumocystis spp. in Human Immunodeficiency Virus-Negative Immunocompromised Patients

Martin Rodriguez and Jay A. Fishman*

Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts

Pneumocystis infection in humans was originally described in 1942. The organism was initially thought to be a protozoan, but more recent data suggest that it is more closely related to the fungi. Patients with cellular immune deficiencies are at risk for the development of symptomatic Pneumocystis infection. Populations at risk also include patients with hematologic and nonhematologic malignancies, hematopoietic stem cell transplant recipients, solid-organ recipients, and patients receiving immunosuppressive therapies for connective tissue disorders and vasculitides. Trimethoprim-sulfamethoxazole is the agent of choice for prophylaxis against Pneumocystis unless a clear contraindication is identified. Other options include pentamidine, dapsone, dapsone-pyrimethamine, and atovaquone. The risk for PCP varies based on individual immune defects, regional differences, and immunosuppressive regimens. Prophylactic strategies must be linked to an ongoing assessment of the patient's risk for disease.

* Corresponding author. Mailing address: Transplant Infectious Disease & Compromised Host Program, Massachusetts General Hospital, 55 Fruit St., GRJ 504, Boston, MA 02114. Phone: (617) 726-5777. Fax: (617) 726-7416. E-mail: jfishman{at}partners.org.

Clinical Microbiology Reviews, October 2004, p. 770-782, Vol. 17, No. 4
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.4.770-782.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Fishman, J. A. (2007). Infection in Solid-Organ Transplant Recipients. NEJM 357: 2601-2614 [Full Text]  
  • Green, H., Paul, M., Vidal, L., Leibovici, L. (2007). Prophylaxis of Pneumocystis Pneumonia in Immunocompromised Non-HIV-Infected Patients: Systematic Review and Meta-analysis of Randomized Controlled Trials. Mayo Clin Proc. 82: 1052-1059 [Abstract] [Full Text]  


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