Pneumocystis pneumonia in children

Pyrgos, Vasilios; Shoham, Shmuel; Roilides, Emmanuel; Walsh, Thomas J.

doi:10.1016/j.prrv.2009.06.010

« Previous Next »Paediatric Respiratory Reviews
Volume 10, Issue 4 , Pages 192-198, December 2009

Pneumocystis pneumonia in children

Vasilios Pyrgos
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USA
- Section of Infectious Diseases, Washington Hospital Center, Washington, DC, USA
Shmuel Shoham
- Section of Infectious Diseases, Washington Hospital Center, Washington, DC, USA
Emmanuel Roilides
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USA
- 3^rd Department of Pediatrics, Aristotle University, Hippokration Hospital, Konstantinoupoleos 49, GR-54642 Thessaloniki, Greece
Thomas J. Walsh
- Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USA
- Corresponding author. Senior Investigator, Chief, Immunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, CRC 1-5750, 10 Center Drive, Bethesda, MD 20892, USA. Tel.: +301 402 0023; fax: +301 480 2308.

Summary

Pneumocystis pneumonia (PCP) is a life-threatening infection in immunocompromised children with quantitative and qualitative defects in T lymphocytes. At risk are children with lymphoid malignancies, HIV infection, corticosteroid therapy, transplantation and primary immunodeficiency states. Diagnosis is established through direct examination or polymerase chain reaction (PCR) from respiratory secretions. Trimethoprim–sulphamethoxazole is used for initial therapy in most patients, while pentamidine, atovaquone, clindamycin plus primaquine, and dapsone plus trimethoprim are alternatives. Prophylaxis of high-risk patients reduces but does not eliminate the risk of PCP. Improved understanding of the pathogenesis of PCP is important for future advances against this life-threatening infection.

Keywords: pneumocystis pneumonia (pcp), immunocompromised children, t-lymphocytes, corticosteroids, trimethoprim–sulphamethoxazole