Pneumocystis jirovecii Pneumonia in Patients with Inflammatory Bowel Disease-a Case Series.
J Crohns Colitis
; 17(4): 472-479, 2023 Apr 19.
Article
em En
| MEDLINE
| ID: mdl-36223253
ABSTRACT
BACKGROUND AND AIM:
Pneumocystis jirovecii pneumonia [PJP] is a very rare, potentially life-threatening pulmonary fungal infection that occurs in immunocompromised individuals including patients with inflammatory bowel disease [IBD]. Our aim was to describe immunosuppressive treatment exposure as well as the outcome in IBD patients with PJP.METHODS:
PJP cases were retrospectively collected through the COllaborative Network For Exceptionally Rare case reports of the European Crohn's and Colitis Organisation. Clinical data were provided through a case report form.RESULTS:
In all, 18 PJP episodes were reported in 17 IBD patients [10 ulcerative colitis and seven Crohn's disease]. The median age at PJP diagnosis was 55 years (interquartile range [IQR], 40-68 years]. Two PJP [11.1%] occurred in patients on triple immunosuppression, 10 patients [55.6%] had double immunosuppressive treatment, four patients [22.2%] had monotherapy and two PJP occurred in absence of immunosuppressive treatment [one in a human immunodeficiency virus patient and one in a patient with a history of autologous stem cell transplantation]. Immunosuppressive therapies included steroids [nâ =â 12], thiopurines [nâ =â 10], infliximab [nâ =â 4], ciclosporin [nâ =â 2], methotrexate [nâ =â 1], and tacrolimus [nâ =â 1]. None of the patients diagnosed with PJP had received prophylaxis. All patients were treated by trimethoprim/sulphamethoxazole or atovaquone and an intensive care unit [ICU] stay was required in seven cases. Two patients [aged 71 and 32 years] died, and one patient had a recurrent episode 16 months after initial treatment. Evolution was favourable for the others.CONCLUSION:
This case series reporting potentially fatal PJP highlights the need for adjusted prophylactic therapy in patients with IBD on immunosuppressive therapy.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Pneumonia por Pneumocystis
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Doenças Inflamatórias Intestinais
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Doença de Crohn
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Transplante de Células-Tronco Hematopoéticas
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Pneumocystis carinii
Limite:
Adult
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Aged
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article