Pneumocystosis is a fungal infection that most often presents as Pneumocystis pneumonia in people with HIV/AIDS or poor immunity. It usually causes cough, difficulty breathing and fever, and can lead to respiratory failure. Involvement outside the lungs is rare but, can occur as a disseminated type affecting lymph nodes, spleen, liver, bone marrow, eyes, kidneys, thyroid, gastrointestinal tract or other organs. If occurring in the skin, it usually presents as nodular growths in the ear canals or underarms.It is caused by Pneumocystis jirovecii, a fungus which is usually breathed in and found in the lungs of healthy people without causing disease, until the persons immune system becomes weakened.Diagnosis is by identifying the organism from a sample of fluid from affected lungs or a biopsy. Prevention in high risk people, and treatment in those affected is usually with trimethoprim/sulfamethoxazole (co-trimoxazole).The prevalence is unknown. Less than 3% of cases do not involve the lungs. The first cases of pneumocystosis affecting lungs were described in premature infants in Europe following the Second World War. Signs and symptoms
Pneumocystosis is generally an infection in the lungs. Involvement outside the lungs is rare but, can occur as a disseminated type affecting lymph nodes, bone marrow, liver or spleen. It may also affect skin, eyes, kidneys, thyroid, heart, adrenals and gastrointestinal tract. Lungs
When the lungs are affected there is usually a dry cough, difficulty breathing and fever, usually present for longer than four weeks. There may be chest pain, shivering or tiredness. The oxygen saturation is low.
These include hyperglucagonemia, zinc deficiency, fatty acid deficiency, hypoaminoacidemia, and liver disease. Mechanism
The pathogenesis is also unknown. Diagnosis
Histology
The histopathologic features of NME are nonspecific and include:
epidermal necrosis
subcorneal pustules
confluent parakeratosis, epidermal hyperplasia, and marked papillary dermal hyperplasia in a psoriasiform pattern
angioplasia of papillary dermis
suppurative folliculitisThe vacuolated, pale, swollen epidermal cells and necrosis of the superficial epidermis are most characteristic. Immunofluorescence is usually negative. Management
Managing the original condition, glucagonoma, by octreotide or surgery. After resection, the rash typically resolves within days. See also
List of cutaneous conditions

References


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