Predisposing factors, clinical characteristics and outcome of Pneumonocystis jirovecii pneumonia in HIV-negative patients.
Pneumocystis jirovecii (former carinii) pneumonia, is a life-threatening opportunistic infection occurring in immunocompromised hosts. The aim of this study was to investigate the predisposing factors, clinical features and outcome of Pneumocystis pneumonia (PCP) in HIV-negative patients. The medical records of 62 adult patients with PCP, hospitalized at the University Hospital of Heraklion, Crete, Greece during a 10-year period (2004-2013) were retrospectively reviewed. All patients were immunosuppressed prior to the development of PCP. Thirty one patients (50%) suffered malignant hematological disease, 16 (26%) solid tumor and 15 (24%) had chronic inflammatory disease. Only 17 (27%) had received long-term systemic corticosteroids. All had symptoms of pneumonia upon admission, while 12 (19%) were suffering respiratory failure. Twenty one (34%) had received trimethoprim/sulfamethoxazole (TMP-SMX) prophylaxis before the PCP onset. Eight patients (13%) were admitted to the ICU. Mortality attributable to PCP reached 29%. Mortality attributable to PCP was higher in patients with solid tumors. TMP-SMX prophylaxis failed in a significant portion of the present cohort. Hence, PCP should be included in the differential diagnosis in immunocompromised patients with symptoms from the respiratory tract even if TMP-SMX has been given as prophylaxis.
Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece. Electronic address: kofterid@med.uoc.gr.
Diamantis P
DP
Kofteridis
Department of Oncology, Mälarsjukhuset Eskilstuna, Sweden.
Antonis
A
Valachis
Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece.
Maria
M
Velegraki
Department of Clinical Microbiology, University Hospital of Heraklion, Crete, Greece.
Maria
M
Antoniou
Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece.
Maria
M
Christofaki
Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece.
George E
GE
Vrentzos
Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece.
Angeliki M
AM
Andrianaki
Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece.
George
G
Samonis
D000368:Aged; D015984:Causality; D005260:Female; D006115:Greece / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D045363:Pneumocystis carinii / Q000187:drug effects; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D015662:Trimethoprim, Sulfamethoxazole Drug Combination
Connective tissue disease; Immunocompromised host; Malignant hematological disease solid tumor; Pneumocystis jirovecii; Pneumocystis pneumonia