Pneumocystis, Pneumonia, Second Edition,

Front Cover
Peter D. Walzer
CRC Press, 1993 M09 1 - 744 pages
This edition examines all aspects of pneumocystis carinii pneumonia, covering advances in understanding the basic biology, epidemiology, pathophysiology, clinical features, diagnosis, treatment and prevention of this pathogen. A section on topics in drug development is included.

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Contents

In Vitro Cultivation
3
Application
17
Antigenic Characteristics of Pneumocystis carinii
107
Transmission and Epidemiology
123
PATHOPHYSIOLOGY
153
Pathological Features
155
Classic Histopathology
157
Unusual Histological Features
158
Outcome
372
Unusual Pulmonary Manifestations of Pneumocystis carinii Pneumonia
373
Pneumothorax
374
Summary
375
DIAGNOSIS
379
Current Methods of Diagnosis
381
Obtaining Specimens
382
Stains
388

Concomitant Processes
171
Disseminated Extrapulmonary Pneumocystis carinii Infection
173
References
174
Animal Models
181
The Classic CorticosteroidTreated Rat Model of Pneumocystis carinii Pneumonia
182
Pneumocystis carinii Infection in Mice
187
Development of Inoculated Rodent Models
190
Pneumocystis carinii Infection in Immunodeficient Mice and Rats
193
Pneumocystis carinii Infection in Other Mammals
202
Pneumocystis carinii Strain and Species Variations
209
Conclusion
213
References
215
Immunodeficient Mice
223
scid Mice and Mechanisms of Immunity to P carinii
225
Nonscid Mouse Models of P carinii
227
P carinii Derived from Mouse Versus Other Species
230
Synergy Between P carinii and Other Organisms
231
Considerations for Colony Maintenance
232
Mechanisms of Pneumocystis carinii Attachment to Lung Cells
237
Pathogenic Mechanisms
251
Humoral and Cellular Immunity
267
Host Defense Effector Mechanisms and Pneumocystis carinii
289
Nonphagocytic Mechanisms of Host Defense Against Pneumocystis carinii
293
Cellular Immunity Cytokines and Epithelial Cells
298
Evasion of Host Defense Effectors by Pneumocystis carinii
303
Conclusions
305
References
306
CLINICAL FEATURES
317
Clinical Manifestations in Children
319
Asymptomatic Infection
320
Immunocompromised Host
321
Extrapulmonary Pneumocystis carinii Infection
326
Prevention
327
Clinical Manifestations in Adults
331
Risk Groups for Pneumocystis carinii Pneumonia
332
Clinical Presentation and Markers for Disease Severity and Prognosis
336
Clinical Course of Pneumocystis carinii Pneumonia
345
Conclusion
349
Extrapulmonary Infection and Other Unusual Manifestations of Pneumocystis carinii
361
Extrapulmonary Infection
362
Clinical Presentation
363
Case Reports
364
Diagnosis and Pathology
371
Indirect Diagnostic Measures
392
Conclusion
394
References
395
A Molecular Approach to the Diagnosis of Pneumocystis carinii Pneumonia
403
Pneumocystis cariniiSpecific DNA Sequences
404
Clinical Studies
408
Epidemiology
411
Conclusions
412
Radiological Approaches to the Diagnosis of Pneumocystis carinii Pneumonia
415
Acute Infection
416
Computed Tomography and Magnetic Resonance Imaging
423
Ultrasound
427
Resolution of Infection
430
Conclusions
431
TREATMENT AND PREVENTION
437
Current Regimens of Therapy and Prophylaxis
439
Treatment
440
Adjunctive Corticosteroids
449
Prophylaxis
450
Treatment and Prophylaxis in Pediatric Patients with Human Immunodeficiency Virus Infection
458
Conclusion and Future Directions
459
References
461
Pharmacokinetic and Pharmacodynamic Considerations for Drug Dosing in the Treatment of Pneumocystis carini Pneumonia
467
TrimethoprimSulfamethoxazole
468
Pentamidine
473
TrimethoprimDapsone
478
ClindamycinPrimaquine
481
Experimental Therapies
482
References
483
Development of Models and Their Use to Discover New Drugs for Therapy and Prophylaxis of Pneumocystis carinii Pneumonia
487
Culture Method
488
Culture Screen
489
In Vitro Evaluations of Folate Pathway Antagonists
494
Folate Antagonists in the Treatment of Pneumocystis carini
545
Pentamidine and Related Compounds in the Treatment
561
Primaquine Other 8Aminoquinolines and Clindamycin
585
Hydroxynaphthoquinones
603
The Use of B13Glucan Synthesis Inhibitors for the Treatment
615
Corticosteroids and Other Adjunctive Agents
633
Author Index
649
Subject Index
701
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