Pneumocystis carinii pneumonia in renal-transplant recipients treated with cyclosporine and steroids.
Fourteen of 156 renal-transplant recipients treated with cyclosporine and steroids developed Pneumocystis carinii-related pneumonia (PCP) over a 19-month period. This was a significant change from past experience with this disease in renal-transplant patients receiving azathioprine and steroids (six cases among 179 patients from 1977 to 1981). Epidemiological investigation failed to implicate either person-to-person or nosocomial spread of infection. Cases of PCP occurred more frequently in males. Twelve patients (86%) had onset of disease in the third or fourth months after transplantation. Comparison of cases to matched controls revealed that the cases had received lower doses of steroids and had a higher incidence of cytomegalovirus infection. This suggested that the cases may have been more effectively immunosuppressed than the controls. After institution of prophylaxis with trimethoprim-sulfamethoxazole, no further cases of PCP developed.
D000293:Adolescent; D000328:Adult; D000368:Aged; D003524:Cyclosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000276:immunology; D004338:Drug Combinations / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000276:immunology* / Q000635:transmission; D012306:Risk; D012737:Sex Factors; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use*; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D003524:Cyclosporins; D004338:Drug Combinations; D013256:Steroids; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole