Martínez-Hernández L, López-Enríquez C, Piedras-Hernández A, Salinas-Herrera VI, Galván-Salazar G

Language: Spanish
References: 33
Page: 280-287
PDF size: 496.38 Kb.

ABSTRACT

Background: Pneumocystis jirovecii pneumonia (PCP) is a potentially fatal lifethreating opportunistic infection that occurs in immunosuppressed patients. Acute respiratory failure with requirement of mechanical ventilation occurs more frequently than in HIV patients.
Clinical case: A 66-year-old female patient with negative triple breast cancer, treated with a chemotherapy and radiotherapy. The patient was admitted in the hospital after one month of progressive dyspnea, with decrease in the functional class and productive cough with fever. Upon her arrival at the emergency room, she had an oxygen saturation of 75%, the laboratory tests on the admission showed high LDH. The chest X rays were normal, and the CT showed pulmonary infiltrate with areas of lung condensation. Antimicrobial treatment was initiated with ceftriaxone, clarithromycin, trimethoprim/ sulfamethoxazole and prednisone. A bronchoscopy revealed cysts forms of P. jirovecii in the Grocott’s methenamine silver stain with a positive P. jirovecii PCR test, making the diagnosis of P. jirovecii pneumonia. Patient required higher ventilator requirements and died three weeks after the hospital admission.
Conclusions: This case exemplifies the aggressive nature of the P. jirovecii pneumonia in the non-HIV population.

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