[Pneumocystis jiroveci pneumonia during prolonged corticosteroid therapy in an immunocompetent infant].
BACKGROUND
Pneumocystis jiroveci (PJ) infection is rare in infants and is suggestive of primary or secondary immunodeficiency. We report on a case of severe PJ pneumonia in an immunocompetent infant after prolonged corticosteroid treatment.


METHODS
A 5 1/2 month-old girl presented with hypoxemic respiratory distress. Her medical record was remarkable only for a bulky parotid haemangioma, which was treated with prolonged oral corticosteroid therapy. The chest X-ray showed a mixed alveolar-interstitial pattern, and bronchoalveolar lavage revealed the presence of PJ. A favourable outcome was obtained after three weeks of intravenous trimethoprim-sulfamethoxazole treatment.


CONCLUSIONS
PJ infection should be suspected in infants presenting with progressive respiratory distress associated with a mixed alveolar-interstitial pattern. Its potential seriousness justifies prophylactic therapy during prolonged immunosuppressive treatment (chemotherapy, corticosteroid treatment).
Guillemot
N
N
Unité de pneumologie pédiatrique, hôpital d'Enfants Armand-Trousseau, AP-HP, 26, avenue du Dr-Netter, 75571 Paris cedex 12, France.
Blanchon
S
S
Nathan
N
N
Corvol
H
H
Fauroux
B
B
Aubertin
G
G
Clement
A
A
Epaud
R
R
D000284:Administration, Oral; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001623:Betamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D018893:Bronchoalveolar Lavage; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D010307:Parotid Neoplasms / Q000188:drug therapy*; D045363:Pneumocystis carinii / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D013902:Radiography, Thoracic; D013997:Time Factors; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000627:therapeutic use
D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D001623:Betamethasone