Diagnosis and management of pneumocystis pneumonia (PCP) in resource-poor settings

Rita Oladele, Akaninyene A Otu, Malcolm Richardson, David Denning

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Abstract

Globally, Pneumocystis pneumonia (PCP) remains a common and lethal infection in both HIV-positive and HIV-negative people, particularly in developing countries where rates of PCP increase with rising GDP. Pneumocystis jirovecii cannot be cultured in routine clinical laboratories, and diagnosis relies on microscopy, histology, serological biomarkers and/or PCR[author: spell out] detection of Pneumocystis DNA; most of these methods are expensive and require proficiency training. Accessing lower respiratory tract specimens in young children is challenging and only PCR testing of nasopharyngeal aspirates is useful. Early diagnosis and treatment with high-dose co-trimoxazole is effective therapy; however, adverse reactions are common. 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 discusses the comparative values of the available diagnostic techniques in relation to their suitability for use in resource-poor settings. We also address the non-availability of the alternative medications in these regions
Original languageEnglish
JournalJournal of Health Care for the Poor and Underserved
Volume29
Issue number1
Early online date27 Feb 2018
DOIs
Publication statusPublished - Feb 2018

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