RT Journal Article
T1 Intermittent Courses of Corticosteroids Also Present a Risk for Pneumocystis Pneumonia in Non-HIV Patients
A1 Calero-Bernal, Maria L.
A1 Martin-Garrido, Isabel
A1 Donazar-Ezcurra, Mikel
A1 Limper, Andrew H.
A1 Carmona, Eva M.
K1 Polymerase-chain-reaction
K1 Jiroveci pneumonia
K1 Carinii-pneumonia
K1 Adjunctive corticosteroids
K1 Clinical characteristics
K1 Respiratory-failure
K1 B-cells
K1 Infection
K1 Innate
K1 Cancer
AB Introduction. Pneumocystis pneumonia (PCP) is rising in the non-HIV population and associates with higher morbidity and mortality. The aggressive immunosuppressive regimens, as well as the lack of stablished guidelines for chemoprophylaxis, are likely contributors to this increased incidence. Herein, we have explored the underlying conditions, immunosuppressive therapies, and clinical outcomes of PCP in HIV-negative patients. Methods. Retrospective analysis of PCP in HIV-negative patients at Mayo Clinic from 2006-2010. The underlying condition, immunosuppressive therapies, coinfection, and clinical course were determined. PCP diagnosis required symptoms of pneumonia and identification of the organisms by visualization or by a real-time polymerase chain reaction. Results. A total of 128 cases of PCP were identified during the study period. Hematological malignancies were the predisposing condition for 50% of the patients. While 87% had received corticosteroids or other immunosuppressive therapies for >4 weeks prior to the diagnosis, only 7 were receiving PCP prophylaxis. Up to 43% of patients were not on daily steroids. Sixty-seven patients needed Intensive Care Unit (ICU) and 53 received mechanical ventilation. The mortality for those patients requiring ICU was 40%. Conclusions. PCP diagnosis in the HIV-negative population requires a high level of suspicion even if patients are not receiving daily corticosteroids. Mortality remains high despite adequate treatment.
PB Hindawi ltd
SN 1198-2241
YR 2016
FD 2016-01-01
LK http://hdl.handle.net/10668/19043
UL http://hdl.handle.net/10668/19043
LA en
DS RISalud
RD Apr 19, 2025