{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:10:08Z","timestamp":1745428208189,"version":"3.40.4"},"reference-count":34,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2016]]},"abstract":"<b><i>Background:<\/i><\/b> Probe-based confocal laser endomicroscopy (pCLE) is a novel technique that provides in vivo microscopic imaging of the distal lung. We hypothesized that the intra-alveolar exudates characterizing <i>Pneumocystis jirovecii <\/i>pneumonia (PJP) can be identified by pCLE in vivo and help in its diagnosis. <b><i>Objectives:<\/i><\/b> We aimed to<b> <\/b>assess the usefulness of pCLE for the in vivo diagnosis of PJP. <b><i>Methods:<\/i><\/b> Thirty-two human immunodeficiency virus (HIV)-positive patients with new pulmonary infiltrates and fever were studied using pCLE. Real-time alveolar images were recorded during the bronchoscopy for off-line analysis by two independent observers. Bronchoalveolar lavage samples were also obtained and processed for microbiology and cytological evaluation, including Grocott stain for <i>P. jirovecii<\/i>. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of pCLE for the diagnosis of PJP in these patients were calculated. <b><i>Results:<\/i><\/b> Fourteen patients (44%) were confirmed to have PJP by cultures\/staining. pCLE was well tolerated in all patients. It identified intra-alveolar exudates in 13 of them (41%), where 11 of them (85%) had positive Grocott stain for <i>P. jirovecci<\/i>, with 93% concordance between observers. Sensitivity, specificity, PPV and NPV of pCLE for the diagnosis of PJP were 79, 89, 85 and 84%, respectively. In smokers, these figures improved to be 92, 88, 85 and 94%. <b><i>Conclusions:<\/i><\/b> pCLE is a quick and safe procedure for on-site diagnosis of PJP in HIV+ patients with excellent specificity and sensitivity mainly in smokers.<\/jats:p>","DOI":"10.1159\/000447431","type":"journal-article","created":{"date-parts":[[2016,6,30]],"date-time":"2016-06-30T22:26:47Z","timestamp":1467325607000},"page":"40-47","source":"Crossref","is-referenced-by-count":14,"title":["Usefulness of Bronchoscopic Probe-Based Confocal Laser Endomicroscopy in the Diagnosis of <b><i>Pneumocystis jirovecii<\/i><\/b> Pneumonia"],"prefix":"10.1159","volume":"92","author":[{"given":"Hanaa","family":"Shafiek","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Fiorentino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Borja 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