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Master Thesis

Impact de la PCR Pneumocystis jirovecii chez les patients suspects de pneumocystose pulmonaire

Abstract : Introduction: Pulmonary pneumocystis (PCP) is a disease of the immunocompromised which frequency is increasing since the advent of new immunosuppressive treatments. Its diagnosis remains complex in the non-HIV subject because the clinical picture is more frustrated and the fungal load lower. Staining is therefore often negative. PCR is an important diagnostic tool but has a low specificity but a negative predictive value of 100%. Objective: To evaluate the impact of PCR on the management of patients with positive PCR and negative staining. Material and method: Monocentric retrospective study at the CHU of CAEN. Patients were classified into two cohorts according to their clinical probability score of having or not having PCP (possible PCP or probable PCP). Their evolution, mortality and sequelae at 3 months were analysed. Results: The study analysed 74 patients (39 probable PCP and 34 possible PCP). PCR was used to strengthen the diagnostic suspicion in 64% of the suspected patients, of whom 10% had an exclusive PCP diagnosis and 41% had other diagnoses. Treatment was initiated in 84% of patients with a high probability. All patients in the study were known to be immunocompromised. There were 18% deaths in the probable PCP group and 32% in the possible PCP group. Conclusion: Pneumocystis jirovecii PCR remains a useful diagnostic tool but cannot be interpreted independently of the clinico-biological context.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03574874
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Submitted on : Tuesday, February 15, 2022 - 12:49:06 PM
Last modification on : Saturday, April 2, 2022 - 3:38:36 AM
Long-term archiving on: : Monday, May 16, 2022 - 7:47:55 PM

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Marzan Sha. Impact de la PCR Pneumocystis jirovecii chez les patients suspects de pneumocystose pulmonaire. Médecine humaine et pathologie. 2021. ⟨dumas-03574874⟩

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