Deterioration of the immune response induced by sulfamethoxazole-trimethoprim in a rheumatoid arthritis patient with Pneumocystis jirovecii pneumonia.
Intern Med
; 53(11): 1137-41, 2014.
Article
em En
| MEDLINE
| ID: mdl-24881737
ABSTRACT
A 73-year-old woman with rheumatoid arthritis treated with methotrexate and prednisolone was admitted with dyspnea and ground-glass opacity on chest CT. We diagnosed her with Pneumocystis jirovecii pneumonia (PCP) based on a positive PCR analysis of Pneumocystis jirovecii and the presence of cysts in bronchoalveolar lavage fluid. The PaO2 was 74.7 Torr on room air, and treatment with sulfamethoxazole-trimethoprim only was initiated. The hypoxemia and ground-glass opacity increased on hospital day 3, and the administration of adjunctive steroid therapy resulted in an improvement in the patient's condition. Although patients with PCP with HIV infection and hypoxemia are often treated with adjunctive steroid therapy to prevent adverse immune reactions, the efficacy of additive steroid administration in case of non-HIV PCP has not been established.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonia por Pneumocystis
/
Artrite Reumatoide
/
Metilprednisolona
/
Combinação Trimetoprima e Sulfametoxazol
/
Pneumocystis carinii
/
Glucocorticoides
/
Anti-Infecciosos
Tipo de estudo:
Diagnostic_studies
Limite:
Aged
/
Female
/
Humans
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article