As nonspecific symptoms are often hindering timely diagnosis, one of the most important diagnostic tools for Pneumocystis pneumonia is a high level of clinical suspicion. Clinicians should always consider this diagnosis in HIV-infected patients that complain of shortness of breath, nonproductive cough and/or fever. Microbiological and molecular methods are then employed as a step towards a final diagnosis.
Microbiological …show more content…
A predilection for the upper parts of the lungs has also been described as a characteristic sign.
Serum markers
Although serum β-D-glucan (which is a part of the cell wall of Pneumocystis and other fungi) is not specific for Pneumocystis infections, the measurement of its level has been used as a useful tool in the diagnosis of Pneumocystis pneumonia, or at least in the screening for the disease.
However, it must be noted that false-positive results can arise due to certain factors such as bacteremia, hemodialysis, certain antimicrobial drugs and the administration of immunoglobulin. In addition, the cut-off value that can be used in the diagnosis of Pneumocystis pneumonia still needs to be determined.
Krebs von den Lungen-6 (abbreviated as KL-6) is another marker that is expressed on pneumocytes and epithelial cells of the bronchi, which acts as a sensitive indicator of different types of interstitial pneumonitis. Therefore in cases of Pneumocystis pneumonia, this marker is elevated as a result of injury and subsequent regeneration of alveolar epithelial