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Advisor(s)
Abstract(s)
A pneumocistose é uma infeção pulmonar causada pelo fungo Pneumocystis jirovecii. A
colonização por este fungo é comum em grande parte da população, mas a infeção ocorre
em indivíduos com imunossupressão, como portadores do vírus da imunodeficiência
humana, doentes submetidos a terapias imunossupressoras ou recetores de transplantes. A
incidência da pneumocistose apresenta uma distribuição mundial heterogénea. Nos países
desenvolvidos, a frequência de casos tem diminuído entre a população infetada pelo vírus
da imunodeficiência humana, devido à ampla adoção da profilaxia e da terapia
antirretrovírica. Por outro lado, em indivíduos não portadores do vírus, a pneumocistose
tem reemergido. Já nos países com menos recursos, onde a incidência da infeção pelo vírus
da imunodeficiência humana é alta, a pneumocistose permanece uma ameaça à saúde das
populações locais.
A pneumocistose pode manifestar-se de forma assintomática em indivíduos
imunocompetentes ou com sintomas como dispneia, tosse não produtiva ou febre em
doentes com um sistema imunitário comprometido. O diagnóstico da pneumocistose pode
ser desafiador, uma vez que exige uma suspeita clínica fundamentada e a utilização de
métodos diagnósticos invasivos ou tecnicamente difíceis de serem realizados em ambientes
com elevada prevalência da doença.
Dado o aumento no número de indivíduos imunodeprimidos, é essencial continuar a
estudar a pneumocistose. Aprofundar a nossa compreensão relativamente à transmissão,
patogénese, tratamento e profilaxia da pneumocistose, poderá alterar a forma como
abordamos esta doença. Esta monografia tem assim como objetivo, realizar uma revisão
bibliográfica que aborde a história, epidemiologia, fisiopatologia e manifestações clínicas
da pneumocistose, bem como as suas diferenças entre doentes com ou sem infeção pelo
vírus da imunodeficiência humana, e reunir os últimos avanços e consensos quanto ao seu
diagnóstico, tratamento e profilaxia.
Pneumocystosis is a pulmonary infection caused by the fungus Pneumocystis jirovecii. Colonization by this fungus is common in a large part of the population, but infection occurs in individuals with immunosuppression, such as those with the human immunodeficiency virus, patients undergoing immunosuppressive therapies or transplant recipients. The incidence of pneumocystosis is heterogeneous around the world. In developed countries, the frequency of cases has decreased among the population infected with the human immunodeficiency virus, due to the widespread adoption of prophylaxis and antiretroviral therapy. On the other hand, in non-infected individuals, pneumocystosis has re-emerged. In countries with fewer resources, where the incidence of human immunodeficiency virus infection is high, pneumocystosis remains a threat to the health of local populations. Pneumocystosis could be asymptomatic in immunocompetent individuals or presents with symptoms such as dyspnea, non-productive cough, or fever in patients with a compromised immune system. The diagnosis of pneumocystosis can be challenging, as it requires a wellfounded clinical suspicion and the use of invasive diagnostic methods or technically difficult to perform in environments with a high prevalence of the disease. Given the increase in the number of immunosuppressed individuals, it is essential to continue studying pneumocystosis. Enhancing our comprehension regarding the transmission, pathogenesis, management, and prevention of pneumocystosis has the potential to revolutionize our approach towards this disease. This review aims to perform a literature analysis that addresses the history, epidemiology, physiopathology, and clinical manifestations of pneumocystosis, as well as its differences between patients with or without human immunodeficiency virus infection, and to gather the latest advances and consensuses regarding its diagnosis, treatment, and prophylaxis.
Pneumocystosis is a pulmonary infection caused by the fungus Pneumocystis jirovecii. Colonization by this fungus is common in a large part of the population, but infection occurs in individuals with immunosuppression, such as those with the human immunodeficiency virus, patients undergoing immunosuppressive therapies or transplant recipients. The incidence of pneumocystosis is heterogeneous around the world. In developed countries, the frequency of cases has decreased among the population infected with the human immunodeficiency virus, due to the widespread adoption of prophylaxis and antiretroviral therapy. On the other hand, in non-infected individuals, pneumocystosis has re-emerged. In countries with fewer resources, where the incidence of human immunodeficiency virus infection is high, pneumocystosis remains a threat to the health of local populations. Pneumocystosis could be asymptomatic in immunocompetent individuals or presents with symptoms such as dyspnea, non-productive cough, or fever in patients with a compromised immune system. The diagnosis of pneumocystosis can be challenging, as it requires a wellfounded clinical suspicion and the use of invasive diagnostic methods or technically difficult to perform in environments with a high prevalence of the disease. Given the increase in the number of immunosuppressed individuals, it is essential to continue studying pneumocystosis. Enhancing our comprehension regarding the transmission, pathogenesis, management, and prevention of pneumocystosis has the potential to revolutionize our approach towards this disease. This review aims to perform a literature analysis that addresses the history, epidemiology, physiopathology, and clinical manifestations of pneumocystosis, as well as its differences between patients with or without human immunodeficiency virus infection, and to gather the latest advances and consensuses regarding its diagnosis, treatment, and prophylaxis.
Description
Keywords
Imunossupressão Pneumocistose Pneumocystis Jirovecii Profilaxia Tratamento