Lethal Pneumocystis jiroveci pneumonia 24 Years After Kidney Transplantation.
BACKGROUND
Pneumocystis jiroveci is an opportunistic infectious fungus in immunosuppressed patients, particularly in ones with acquired immunodeficiency syndrome (AIDS). The use of immunosuppressive drugs especially corticosteroids predisposes the transplanted patients to a variety of infectious diseases including Pneumocystis infection. In many developed countries, the incidence of Pneumocystis jiroveci pneumonia (PJP) is dwindling in transplant patients receiving appropriate prophylaxis. In this study, definitive diagnosis of Pneumocystis infection in a patient receiving kidney transplant was presented.


METHODS
The patient was a 45-year-old man with a history of kidney transplantation 24 years ago, admitted to a specialized hospital in Tehran because of fever and respiratory distress. Upon admission, the patient showed symptoms of unconsciousness and shortness of breath. Paraclinical tests and complementary examinations such as microscopic observation and molecular analysis confirmed the definitive diagnosis of Pneumocystis infection. Specific treatment with trimethoprim/sulfamethoxazole was carried out alongside other therapeutic measures; but unfortunately the patient did not respond to the specific treatment and died in the course of a progressive disease.


CONCLUSIONS
The disease progress in these patients can still be fast and deadly. Applying rapid molecular diagnostic techniques to start appropriate and timely treatment is essential. Utilization of such diagnostic methods is recommended in our country.
Department of Parasitology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran.
Babak
B
Rezavand
Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Mohammad Javad
MJ
Hosseini
Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Morteza
M
Izadi
Department of Parasitology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, IR Iran.
Abbas
A
Mahmoodzadeh Poornaki
Department of Parasitology, Medical School, Tarbiat Modares University, Tehran, IR Iran.
Javid
J
Sadraei
Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Behzad
B
Einollahi
Departmanet of Laboratory Sciences, Health Research Center, Birjand University of Medical Sciences, Birjand, IR Iran.
Mohammad Reza
MR
Rezaimanesh
Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Ozra
O
Bagheri
Department of Parasitology, School of Medicine, Ilam University of Medical Sciences, Ilam, IR Iran.
Jahangir
J
Abdi
Kidney Transplantation; Pneumonia, Pneumocystis jiroveci; Polymerase Chain Reaction