Treatment of Pneumocystis jirovecii pneumonia in non-human immunodeficiency virus-infected patients using a combination of trimethoprim-sulfamethoxazole and caspofungin  

作　　者：Huan-Huan Wu Shuang-Yan Fang Yan-Xiao Chen Lan-Fang Feng 

机构地区：[1]Department of Respiratory Medicine,Dongyang Hospital Affiliated to Wenzhou Medical University,Dongyang 322100,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2022年第9期2743-2750,共8页世界临床病例杂志

摘　　要：BACKGROUND Pneumocystis jirovecii pneumonia(PJP)is an infectious disease common in immunocompromised hosts.However,the currently,the clinical characteristics of non-HIV patients with PJP infection have not been fully elucidated.AIM To explore efficacy of trimethoprim–sulfamethoxazole(TMP-SMX)and caspofungin for treatment of non-human immunodeficiency virus(HIV)-infected PJP patients.METHODS A retrospective study enrolled 22 patients with non-HIV-infected PJP treated with TMP-SMX and caspofungin from 2019 to 2021.Clinical manifestations,treatment and prognosis of the patients were analyzed.RESULTS Five patients presented with comorbidity of autoimmune diseases,seven with lung cancer,four with lymphoma,two with organ transplantation and four with membranous nephropathy associated with use of immunosuppressive agents.The main clinical manifestations of patients were fever,dry cough,and progressive dyspnea.All patients presented with acute onset and respiratory failure.The most common imaging manifestation was ground glass opacity around the hilar,mainly in the upper lobe.All patients were diagnosed using next-generation sequencing,and were treated with a combination of TMP-SMX and caspofungin.Among them,17 patients received short-term adjuvant glucocorticoid therapy.All patients recovered well and were discharged from hospital.CONCLUSION Non-HIV-infected PJP have rapid disease progression,high risk of respiratory failure,and high mortality.Combination of TMP-SMX and caspofungin can effectively treat severe non-HIVinfected PJP patients with respiratory failure.

关 键 词：Acquired immunodeficiency syndrome Non-human immunodeficiency virus-infected patients IMMUNOSUPPRESSION CASPOFUNGIN MORTALITY Pneumocystis jirovecii pneumonia 

分 类 号：R512.91[医药卫生—内科学] R563.1[医药卫生—临床医学]