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Pneumocystis jirovecii pneumonia in an immunocompetent patient recovered from COVID-19
- Publication Year :
- 2021
-
Abstract
- Background: Several cases of invasive fungal diseases in patients with COVID-19 have been reported, mostly due to Aspergillus spp., with anecdotic reports of Pneumocystis jirovecii pneumonia (PJP) as co-infections in immunocompromised patients. We describe the first case of PJP in an immunocompetent patient who recovered from COVID-19 pneumonia. Case description: Our patient was hospitalized for 18 d for respiratory failure due to Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pneumonia and successfully treated with continuous positive airway pressure (CPAP) respiratory support, enoxaparin, ceftaroline and intravenous 6 mg of dexamethasone for 10 d, then with oral prednisone tapering. Despite his improved radiological and clinical conditions at discharge, he was admitted again after 18 d for worsening of respiratory conditions. Upon the second admission, a high-resolution CT-scan of the chest showed the development of new ground-glass opacities and P. jirovecii was detected on bronchoalveolar lavage fluid. A therapy with trimethoprim-sulphamethoxazole 20 mg/kg and methylprednisolone 40 mg i.v. bis in die (BID) was started, with improvement of clinical, biochemical and radiological conditions. Conclusions: COVID-19 patients may have multiple risk factors for development of PJP, in particular lymphopaenia and use of steroids. PJP must be ruled out with direct microbiological methods in patients presenting with radiologic and clinical features of possible or probable PJP, even in immunocompetent hosts.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
2019-20 coronavirus outbreak
Coronavirus disease 2019 (COVID-19)
030106 microbiology
03 medical and health sciences
0302 clinical medicine
parasitic diseases
Medicine
Pneumocystis jirovecii
In patient
030212 general & internal medicine
Aspergillus
General Immunology and Microbiology
biology
business.industry
SARS-CoV-2
Pneumocystis jirovecii Pneumonia
COVID-19
General Medicine
biology.organism_classification
Virology
invasive fungal disease
Infectious Diseases
Pneumocystis carinii
lymphopaenia
Immunocompetence
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....63b71bc438f7f7e74b0c9603ed22b57f