Pneumocystis jirovecii pneumonija u osobe oboljele od HIV/AIDS-a

master's thesis

• Title (english): Pneumocystis jirovecii pneumonia in a person with HIV/AIDS
• Author: Marko Lukšić
• Mentor: Marija Santini (mentor)
• Committee member: Neven Papić (predsjednik povjerenstva)
• Committee member: Goran Tešović (član povjerenstva)
• Committee member: Marija Santini (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Pneumocystis jirovecii je gljiva koja se prenosi zračnim putem, često s osobe na osobu, ali moguća je i de novo infekcija iz okoliša, te reaktivacija postojeće, latentne infekcije. Pneumocystis jirovecii pneumonija (PJP) je vodeća oportunistička bolest kod osoba s uznapredovalom fazom HIV infekcije u Hrvatskoj i na području Europske unije. U ovom radu prikazan je slučaj HIV pozitivnog bolesnika s PJP. Bolest se prezentirala postupno progredirajućim simptomima tijekom razdoblja od otprilike jedne godine. Klinička slika je u početku bila blagog, nespecifičnog karaktera, ali je s vremenom došlo do razvoja teškog općeg stanja. Nakon ustanovljenje ezofagealne kandidijaze i pozitivnog radiološkog nalaza na plućima, postavlja se sumnja na HIV infekciju, koja je potvrđena serološkim pretragama. Konačno, PCR-om na uzorku bronhoalveolarne lavaže dokazana je infekcija gljivom P. jirovecii, te je postavljena dijagnoza PJP. Započeta je terapija sulfometoksazolom i trimetoprimom u kombinaciji sa kortikosteroidima, koja dovodi do poboljšanja kliničkog stanja pacijenta. PJP se sve češće dijagnosticira kod non-HIV imunokompromitiranih osoba, prezentirajući se često značajkama atipične pneumonije, što može predstavljati značajan dijagnostički izazov.
Slučaj prikazan u ovom radu doprinosi dosadašnjim spoznajama o ovoj čestoj oportunističkoj infekciji koja se javlja u HIV, ali i non-HIV imunokompromitiranih bolesnika.

Abstract (english)

Pneumocystis jirovecii is a fungus that is transmitted airborne, often from person to person, but de novo infection from the environment and reactivation of an existing, latent infection are also possible. Pneumocystis jirovecii pneumonia (PJP) is the most common opportunistic dis- ease in people with an advanced stage of HIV infection in Croatia and the European Union. This article presents the case of an HIV-positive patient with PJP. The disease presented itself with gradually progressing symptoms over a period of about one year. The clinical picture ini- tially had a mild, non-specific character, but over time it developed into a serious general con- dition. After the establishment of esophageal candidiasis and a positive radiological finding on the lungs, HIV infection is suspected, which was confirmed by serological tests. Finally, PCR of the bronchoalveolar lavage sample showed infection with the fungus P. jirovecii and the diagnosis of PJP was made. Sulfomethoxazole and trimethoprim therapy was started in com- bination with corticosteroids, which led to an improvement in the patient's clinical condition. PJP is increasingly diagnosed in non-HIV immunocompromised individuals, often presenting with features of atypical pneumonia, which can represent a significant diagnostic challenge.
The case presented in this thesis contributes to the current knowledge about this common opportunistic infection that occurs in HIV and non-HIV immunocompromised patients.

• Keywords: HIV; AIDS; Pneumocystis jirovecii; Pneumocystis jirovecii pneumonija; imunokompromitiranost
• Keywords (english): HIV; AIDS; Pneumocystis jirovecii; Pneumocystis jirovecii pneumonia; immuno- compromised
• Language: croatian
• URN:NBN: urn:nbn:hr:105:694238
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-10 09:09:30