In Honor of Otto Jírovec

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If I could talk to Otto (if you don´t know who Otto Jírovec is, but you know Taylor Swift ... stay calm and keep reading. Old school), I’d start by telling him that a lot of things have changed since his days of describing that “interesting rare pneumonia in children” back in the 1930s. I’d mention the internet, AI, the Human Genome Project… and of course, Instagram.

But then I’d have questions — serious ones.

How is it possible that 40+ years later, with all our technology, Pneumocystis jirovecii is still unculturable?
Yes, Otto, we named a bug after you. And second surprise: it’s a fungus. And to be fair, it’s a weird fungus — no ergosterol, lots of glucans.


Then I’d explain that today we have four treatment options:

(SPOILER ALERT: not antifungals)

  • TMP-SMX (oral or IV) — Gold standard 

  • Atovaquone - an inhibitor of mitochondrial Complex III

  • Clindamycin + primaquine

  • Pentamidine - a.k.a. Thanos  [No Otto,  I wont even try to explain that]

Oh, I almost forgot… steroids.

We now use the A–a gradient — an unnecessarily terrific formula — and if it’s more than 35 mmHg, or if PaO₂ is less than 70 mmHg, or the saturation is under 92%, congratulations: 21 days of prednisone and sweeter lungs.


But I am tired of all this sarcasm; I need to ask the real question.
If I ever had the chance to talk to this great great man, I would ask: do you prefer Pneumocystis “yee-roh-veh-chee” or “yee-roh-veh-kee”?

Trust me, the man deserves at least that much.





💨Philip A. Mackowiak, Mohammad M. Sajadi, George T. Fantry, Lori E. Fantry, A Czech Researcher and Pneumocystis, Clinical Infectious Diseases, Volume 39, Issue 2, 15 July 2004, Pages 270–271, https://doi.org/10.1086/422005

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