Late-onset Pneumocystis jirovecii pneumonia in solid organ transplant recipients.
Anti-Pneumocystis prophylaxis is recommended for at least 6-12 months after solid organ transplantation, as most cases of Pneumocystis jirovecii pneumonia (PCP) occur during the first year post transplantation. Herein, we report 4 cases of late-onset PCP (>1 year post transplant). PCP appeared in a range of 50-68 months post transplant. Two cases had history of humoral rejection episodes treated with rituximab, and the other 2 had low CD4+ T-cell count (<200 cells/mm(3) ) at the time of diagnosis. All 4 patients survived. In conclusion, although the number of cases is low, we must be aware of the possibility of late-onset PCP in solid organ transplant patients. The role of previous use of rituximab or persistent CD4+ T-cell lymphopenia should be addressed in future studies.
Department of Infectious Diseases, Hospital Clinic de Barcelona-University of Barcelona, Barcelona, Spain.
L
L
Perez-Ordoño
I
I
Hoyo
G
G
Sanclemente
M J
MJ
Ricart
F
F
Cofan
F
F
Perez-Villa
J Puig
JP
de la Bellacasa
A
A
Moreno
C
C
Cervera
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D013997:Time Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
PCP; Pneumocystis jirovecii; late-onset opportunistic infection; lymphopenia; rituximab; solid organ transplantation