Talk:Pneumocystis pneumonia

Proposed Name change
Pneumocystis jirovici has been proposed as a new name for Pneumocystis carinii. There is also interest in re-classifying this organism as a fungus.

Yes the organism is clearly a fungus. Unfortunately there is a common misperception regarding the name, which is not a change. The name Pneumocystis jiroveci, which is now corrected to Pneumocystis jirovecii, was proposed as a new name only for the human form previously identified as Pneumocystis carinii. Not all of Pneumocystis carinii is named Pneumocystis jirovecii. The name Pneumocystis carinii still applies to a rat parasite. Other taxa formerly classified as Pneumocystis carinii are now described as other species, namely P. murina in mice, P. wakefieldiae also in rats, and most recently, P. oryctolagi from rabbits. However, recognition of all of these taxa as species rather than other levels of classification will continue to be debated. Heliocybe 14:00, 14 March 2007 (UTC)

See this article at the Centers for Disease Control website for more on the proposed new name and classification for Pneumocystis carinii. JWSchmidt 07:16, 25 Mar 2004 (UTC)


 * This is no longer just a proposed change, but Pneumocystis jirovici is now the officially supported name by both the CDC and the WHO. I will rename the article accordingly. See the reference at Pneumocystis carinii pneumonia. &mdash; Brim 16:24, Feb 15, 2005 (UTC)

Bad mistake
This nomenclature is not universally accepted, and should probably not be, as well-elucidated in the following...

http://www.findarticles.com/p/articles/mi_m0GVK/is_2_9/ai_98250060


 * Anonymous editor: that's a letter from two years ago, and even if it were more recent, it wouldn't make anything as clear-cut as you seem to think. First, as it acknowledges, the previous taxonomy of P. carinii never had unanimous consensus among international organizations either - even regarding whether it was a protozoan or a fungus - and yet that didn't stop virtually everyone in medical practice from accepting that it was a fungus and calling it PCP. And in fact, they still call it PCP - with the PC now standing for Pneumocystis instead of P. carinii - addressing the letter-writer's other concern, that the name change would confuse AIDS patients. (I think the authors were really stretching for complaints; they even included a snarky suggestion that "jiroveci" is too hard to pronounce!) Anyway, if you'd like to add a mention of this controversy to our article, go ahead... but it doesn't mean the article isn't still a good description of the current state of the art. &#8592;Hob 22:28, 18 December 2005 (UTC)

"more correctly"?
An anonymous editor wrote "Pneumocystis jiroveci or, more correctly, Pneumocystis jirovecii". This is wrong - there would be a double I if it had been named after someone whose name already ended in I (such as Antonio Carini), but the person's name is Jírovec, so jiroveci is correct. &#8592;Hob 21:27, 30 October 2005 (UTC)


 * Actually, you know who's wrong? Me. ICBN rules say so. Sorry! However, people go on using jiroveci and ICBN hasn't ruled on it, so I updated the article to include both. &#8592;Hob 06:02, 20 December 2005 (UTC)

history & references
A helpful anonymous editor has added a History section, but I think at least some of that really belongs in the Pneumocystis jiroveci article rather than here - or maybe both. Comments?

Also, we now have a lot of references to articles between 50 and 90 years old, many in languages other than English. I recognize the historical value of these, but I'm not sure they work as references for an English-language encyclopedia article, since most readers here will not be able to use them to verify anything. &#8592;Hob 19:43, 21 January 2006 (UTC)

--

IMHO the historical material belongs both here and in the Pneumocystis jiroveci article. They describe the history of the recognition of Pneumocystis pneumonia (which is clearly relevent to the article) and also why the organism was thought for many years to be a protozoan despite its unusual antibiotic sensitivies and other features.

Also IMHO the historical references should stay. Firstly because they are the primary sources of this material. The primary sources should alway be provided when they can be identified. Remarking that these may not available to English speaking people is likely to be incorrect. Many readers of Wikipedia are at least bilingual and collectively have access to libraries and other sources. Secondly Google's programme of copying of public domain material from acedemic and other libraries may make many source documents widely available in the near future. Once these are available some will be translated and others can be read with facilities such as babelfish. Finally the suggestion that only primary source documents written in English have any value on the English version of Wikipedia is not even worth commenting on.


 * Anonymous editor: Saying it's "not even worth commenting on" is of course a comment, and a rather harsh one considering that I haven't deleted anything. I did not say that only English-language references "have any value", but just that they won't be useful for most of our readers, thus they shouldn't be the only reference for important bits of information. This applies to editors too - editors who can't speak German, French, or Czech are unable to verify that the article is describing the content of the references accurately. Please see Verifiability. &#8592;Hob 14:36, 27 January 2006 (UTC)


 * Hob - Fair comment. The 'non comment' does sound a bit harsh but the earlier one did not seem to make a lot of sense. It is a fairly standard proceedure in the academic literature to list the orginal sources - where they can be found. This may or may not be consistent with Wikipedia intentions but IMHO seems a sensible thing to do. Others' milage may differ.
 * As to every editor being able to verify the content of every listed reference is correctly summaried - well that IMHO assumes a bit much of the average editor. There are a few things I know about but (say) the depths of string theory are currently a bit beyond me. So does this mean that all refs to string theory should be removed? I dont see that working as a policy. To be honest, I dont think this quite is what you meant but that is one possible - if rather extreme - interpretation of what you wrote.
 * I can get by in five languages (including French) and speak bits of a sixth. Czech isnt one of them (yet). If I come across an on line translation of these papers I will link to it. This maybe sooner than one might expect if Google's project goes ahead. IMHO there might also be some additonal value in posting these refs. It is possible that at least one editor somewhere might have a copy in a back drawer of these papers. If it not on line then thier memory would not be jogged. I for one would love to find the Chagas paper as it seems Chagas - I have read - confused this organism with the trypanosomes that he did discover. Hence the importance of the later papers clearing this confusion up. I have not written this up simply because Im not absolutely sure about the details even if the story is fairly credible.
 * For what its worth, the editors here - including Hob :-) - have done a very decent job on this organism. Please keep up the good work.


 * Look, it's not a matter of my personal opinion, it's part of WP consensus which is explained in the link I posted above. It doesn't say you can't use foreign-language sources, it just says it's not a great idea for them to be the only sources. And it has nothing to do with whether the average editor can understand the theory behind them; it's just that if an editor writes something like "P. jiroveci is spontaneously generated from cat fur (Schmo, 1991)" and some other editor claims Dr. Schmo said nothing of the kind, it would be nice to be able to refer the article to clear this up, since none of what we write here is peer-reviewed ahead of time. That's an admittedly silly example but it's the reason for this general principle. &#8592;Hob 19:32, 3 February 2006 (UTC)


 * Sounds very reasonable. However there does appear to be a small hole in the logic. When doing a history secton, you do want the history: this means the primary documents where possible. As a general principle, what you say does seem like a good idea but pehaps exceptions should be made for odd ball areas like this.


 * No, it's not really a loophole, because I didn't say to get rid of those sources! I just said it's not a good idea for the only sources to be either (a) non-English-language or (b) fifty years old. Don't get rid of them. Just, if you happen to have another general reference that's newer and/or in English, please add that too. If you don't, someone else eventually will. That's all. &#8592;Hob 21:53, 5 February 2006 (UTC)

Help needed to rename/move/correct title of page
Being new to Wikipedia I realize I am not as familiar with protocols and methods as I need to be. The current title (name) for this page is incorrect, and therefore I tried to move/rename it but have gone in circles. Being a significant topic I would like to ensure this is done correctly.

The reasons it needs to be changed are several. Firstly, jiroveci is not correct. The species epithet is correctly spelled jirovecii according to the International Code of Botanical Nomenclature (Vienna Code 2006), the Code that governs fungal names. In fact Pneumocystis jirovecii is cited as an example in Example 8 for Article 45. There is no dispute on this matter. It is a correction under Art. 60.11 from the original spelling as jiroveci under the Zoological Code.

Secondly, PCP originally stood for Pneumocystis carinii pneumonia. The Pneumocystis working group now recognizes Pneumocystis jirovecii as the correct name for the causal agent for the human form of Pneumocystis, but decided that the acronym PCP could stand for Pneumo-, -cystis pneumonia, rather than change the acronym. It makes no sense to start calling it Pneumocystis jirovecii pneumonia which would abbreviate as PJP not PCP. Admitedly I do see Pneumocystis 'jiroveci' pneumonia being used in some literature, but it is not sanctioned by the Pneumocystis working group. Therefore, I would like to redirect the incorrectly spelled and perhaps inappropriately named page to a standard Pneumocystis pneumonia (PCP) named page, and in there explain the history. Thus far I have edited this page but cannot rename it because my attempted move goes in circles.

So I ask your help and advice. Heliocybe 13:38, 19 March 2007 (UTC)


 * Complex move requests should be posted at Move requests. -- MarcoTolo 21:36, 19 March 2007 (UTC)

The proposed moves and mergers are complex. The reasons for the suggested changes are several. To begin with, the spelling of the species epithet “jiroveci” is not correct. The species epithet is correctly spelled with two letters “ii” as “jirovecii” according to the International Code of Botanical Nomenclature (the latest edition being the Vienna Code 2006). The genus Pneumocystis is a fungal genus, not a protozoan genus, and therefore it is the Botanical Code that governs the spelling of fungal species epithets. In fact “Pneumocystis jirovecii”, spelled this way is specifically cited as an example in Example 8 for Article 45. Therefore, there is no longer any dispute on this matter as has been implied in some discussions. The spelling as “jirovecii” was a correction under Art. 60.11 from the original spelling as “jiroveci” as originally published under the International Code of Zoological Nomenclature. However, in addition to being spelled incorrectly, there is the larger issue of confusion over the acronym PCP, the identification of the human pathogen as Pneumocystis carinii, and the coining of new terms, and redundancy of information under some names. The least confusing way to index all of the Pneumocystis-related sites on Wikipedia, is to move or merge them under one explanatory site name, and the most neutral to my mind is Pneumocystis pneumonia (PCP). I have edited the text currently under the name Pneumocystis jiroveci pneumonia with additional explanation and would like to see the entire content moved to the Pneumocystis pneumonia (PCP) page as a start. PCP originally stood for Pneumocystis Carinii Pneumonia. However, a professional group, The Pneumocystis working group, now recognizes Pneumocystis jirovecii as the correct name for the causal agent for the human form of Pneumocystis, but decided that the acronym PCP could stand for Pneumo-, -Cystis Pneumonia, rather than change the familiar acronym. Although the phrase name Pneumocystis jirovecii pneumonia has arisen on the WWW and in some literature, it would abbreviate as PJP not PCP, but this is not recommended by the group. Hence, redirecting Pneumocystis jiroveci pneumonia to Pneumocystis pneumonia (PCP) rather than simply correcting the spelling of “jiroveci” is recommended. It follows from this that the name pages Pneumocystis jirovecii and Pneumocystis jiroveci also be redirected. The information on the Pneumocystis jiroveci page is largely, if not totally, redundant and should be merged with the contents under Pneumocystis pneumonia (PCP) after including contents from Pneumocystis jiroveci pneumonia under that name. Currently Pneumocystis pneumonia (PCP) redirects to Pneumocystis jiroveci pneumonia but this should be reversed, of course. Similarly, currently Pneumocystis carinii redirects to Pneumocystis jiroveci pneumonia because of the convoluted history of PCP. It should go to Pneumocystis pneumonia (PCP) as well. Finally, the contents under Pneumocystis page is redundant, except for the species list. That page should also be merged, so that only a single entry is recognized, namely Pneumocystis pneumonia (PCP) with all of the information on Pneumocystis in humans (for now). I have additional comments if there are questions regarding these changes. Heliocybe 18:29, 23 March 2007 (UTC)
 * I have copied the following extended reasoning from WP:RM. --Stemonitis 19:05, 23 March 2007 (UTC)

I completed the moving, redirecting and merging of data from several pages, Pneumocystis jiroveci, Pneumocystis jiroveci pneumonia, Pneumocystis, to Pneumocystis pneumonia (PCP). see Talk:Pneumocystis pneumonia (PCP) Heliocybe 15:40, 28 March 2007 (UTC)

Moves, redirects and merges
I completed the moving, redirecting and merging of data from several pages, Pneumocystis jiroveci, Pneumocystis jiroveci pneumonia, Pneumocystis, etc. I reworded some, removed redundant data, added references. However, my expertise is NOT Pneumocystis pathology, treatment, diagnosis, or even molecular analysis. I noticed a contradiction in symptoms (high fever versus low grade fever) between the old discussions under Pneumocystis jiroveci and Pneumocystis jiroveci pneumonia old pages. Could those more familiar with the disease symptoms or those more familiar with treatment & diagnosis please check & edit appropriately those sections. I am much more confident about the history, nomenclature, and systematics. It has also been suggested by another editor that all of this be best treated under the simpler moniker "Pneumocystis pneumonia" rather than "Pneumocystis pneumonia (PCP)". I'm not certain what is best. Heliocybe 15:37, 28 March 2007 (UTC)

I thought I was logged on when making changes just now, hence the anonymous edit. Heliocybe (talk) 17:09, 7 November 2008 (UTC)

redirect
This seems to be a standardization of Wikipedia page naming conventions which is acceptable. The important thing is to collate the information one location. Heliocybe 13:58, 30 March 2007 (UTC)

Co-trimoxazole vs. trimethoprim/sulphamethoxazole
May I be so bold as to suggest that we stick to one or the other for the entire document? Given that co-trimoxazole is the Wikipedia article, may I suggest that we use that? And then any Americans unfamiliar with that usage can click on the link to find out what it is! --Gak 13:41, 7 May 2007 (UTC)

This should be decided by others, not me, as I am unfamiliar with these drugs. You could simply be bold and make the change. Heliocybe 17:06, 7 May 2007 (UTC)

Protozoan references
I removed the link to protozoal diseases which on other pages for other organisms looks to be useful, but it is now well established that Pneumocystis is a fungal genus, not a protozoan genus. Heliocybe 13:53, 4 July 2007 (UTC)

Human to human transmission
Multiple articles easily found online suggest that human-to-human transmission of pneumocystis carovecii is possible, for example: "Transmission of Pneumocystis carinii DNA from a patient with P. carinii pneumonia to immunocompetent contact health care workers.Vargas SL, Ponce CA, Gigliotti F, Ulloa AV, Prieto S, Muñoz MP, Hughes WT. Program in Microbiology, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago. svargas@reuna.cl" Maybe this needs reviewing by an another expert on this subject? —Preceding unsigned comment added by 86.87.165.76 (talk) 14:47, 7 November 2007 (UTC)

I agree with you, I have tried to update the relevant text accordingly. Addition of more references would be useful. MidgeMcEwan (talk) 13:12, 30 September 2008 (UTC)

Pronunciation
Can anyone give a definite pronunciation of the word "JIROVECI". I'm hearing so many different things these days!!! —Preceding unsigned comment added by Leo71538 (talk • contribs) 19:48, 11 November 2008 (UTC)

It's a Czech name and is pronounced Yeero-vets-ee-eye —Preceding unsigned comment added by 194.176.105.56 (talk) 10:20, 24 February 2010 (UTC)

The pronunciation is. See sources cited below.
 * Pneumocystis jirovecii (pronounced NEW-mo-SIS-tis yee-row-VET-zee)

Senator2029&#8239;•&#8239;talk 05:27, 3 November 2012 (UTC)
 * They kindly reminded us to use the term P jirovecii (pronounced “yee row vetzee”), in honor of Czech parasitologist Otto Jírovec.

Pathophysiology - dyspnea?
The sentence "Oxygen is less able to diffuse into the blood, leading to hypoxia. Hypoxia, along with high arterial carbon dioxide (CO2) levels, stimulates ventilation, thereby causing dyspnea." is confusing. Is hypercapnia truly a feature of PCP; and if not, why drag in mention of CO2 levels? I thought CO2 diffuses readily even across thickened alveolar walls, so that it would be hypoxia that causes dyspnea and, indeed, that if anything it would be hypocapnea that would be observed. Myron (talk) 08:54, 17 April 2009 (UTC)

Introduction rewrite
I changed the introduction back to the previous version because the rewrite again begins to blur the distinction between P. jirovecii and P. carinii. By stating without qualifications that P. jirovecii used to be called P. carinii merely sounds like a change in name for one species when in fact they are being recognized as two species, one in rats (P. carinii) and one in humans (P. jirovecii). Currently the wording carefully distinguishes the two while acknowledging that the name P. carinii had been applied to Pneumocystis in humans.

Also, I removed the word "organism" in the other changed section because it was not necessary and it is confusingly general - what "organism"? What was meant was cyst or cell, which is redundant. However, I cannot speak to the actual clinical diagnostic characteristics. This is for others to judge. Heliocybe (talk) 12:07, 4 May 2009 (UTC)

Edits to shorten article
There is still sufficient confusion regarding the names to warrant the longer explanation. Please do not shorten it to the extent that you did. If you want to discuss this, we can do so here. Heliocybe (talk) 11:50, 4 August 2009 (UTC)


 * The introduction should be as compact as possible en overlap with the rest of the article should be avoided. I clearly pointed out that there is a difference between the two names and further on in the article it is explained in detail.


 * The question of the protozoans is not of importance here and makes it unclear. The last sentence only evokes confusion and incomprehencion.--Wickey-nl (talk) 13:24, 4 August 2009 (UTC)

Ok - let me look at it with this in mind and see how best to resolve this (perhaps tomorrow). Clearly it is not clear for you, which means something should be changed.Heliocybe (talk) 16:57, 5 August 2009 (UTC)

In other articles the disease is separated from the cause, like in Schistosomiasis, Streptococcus pneumoniae and Lyme disease.--Wickey-nl (talk) 15:49, 7 August 2009 (UTC)
 * Confusion about jirovecii in animals may be a presumed problem that does not exist. If there are many people who think so, which I doubt, it could be explained in a separate chapter about host specificity. Not in the intro. It is an item of the taxonomy, not of the disease.

Translation into English, please?
This article as it stands now contains such a concentration of unexplained medical terms that it is, in my estimation, beyond the grasp of the average reader. I myself have a relatively good grasp on Latin and some medical background, and even I cannot understand even half of the article. —Preceding unsigned comment added by 82.83.152.184 (talk) 00:40, 19 September 2010 (UTC)

Naming
I've deleted the claim that Pneumocystis carinii was "named after Dr C. Simonian", as it is unsupported by the source given. Also, AFAIK the name "carinii" comes from the Greek for a keel, due to the appearance of the organism under a microscope. Does anyone know for sure? Moonraker12 (talk) 11:06, 26 July 2012 (UTC)