Diagnosis and Management of Pneumocystis Pneumonia in Resource-poor Settings.

TitleDiagnosis and Management of Pneumocystis Pneumonia in Resource-poor Settings.
Publication TypeJournal Article
Year of Publication2018
AuthorsOladele, RO, Otu, AA, Richardson, MD, Denning, DW
JournalJ Health Care Poor Underserved
Volume29
Issue1
Pagination107-158
Date Published2018
ISSN1548-6869
Abstract

Globally, Pneumocystis pneumonia (PCP) remains a common and lethal infection in both HIV-positive and HIV-negative patients, particularly in developing countries where rates of PCP increases with rising GDP. Pneumocystis jirovecii cannot be cultured in routine clinical laboratories; thus diagnosis relies on microscopy, histology, serology and/or polymerase chain reaction (PCR) of the Pneumocystis DNA. Most of these methods are expensive and require training. Accessing lower respiratory tract specimens in young children is often challenging and only PCR testing of nasopharyngeal aspirates is useful. Early treatment with high-dose co-trimoxazole is effective therapy; however, adverse reactions are common along with reports of emerging resistance. Improved outcomes are associated with adding corticosteroid to treatment in those with moderate/severe PCP, although this has not been studied in resource-poor settings. This review compares the available diagnostic techniques in relation to their suitability for use in resource-poor settings. We also addressed the non-availability of the alternative medications in these regions.

DOI10.1353/hpu.2018.0010
Alternate JournalJ Health Care Poor Underserved
PubMed ID29503291