Successful treatment of a kidney transplant patient with COVID-19 and late-onset Pneumocystis jirovecii pneumonia

被引:7
|
作者
Peng, Jing [1 ]
Ni, Ming [2 ]
Du, Dunfeng [3 ]
Lu, Yanjun [1 ]
Song, Juan [4 ]
Liu, Weiyong [1 ]
Shen, Na [1 ]
Wang, Xiong [1 ]
Zhu, Yaowu [1 ]
Vallance, Bruce A. [5 ]
Sun, Ziyong [1 ]
Yu, Hong Bing [5 ]
机构
[1] Huazhong Univ Sci & Technol, Tongji Hosp, Dept Lab Med, Tongji Med Coll, Wuhan, Peoples R China
[2] Huazhong Univ Sci & Technol, Tongji Hosp, Dept Infect Dis, Tongji Med Coll, Wuhan, Peoples R China
[3] Huazhong Univ Sci & Technol, Inst Organ Transplantat, Tongji Hosp, Tongji Med Coll, Wuhan, Peoples R China
[4] Wuhan 9 Hosp, Dept Gastroenterol & Endocrinol, Wuhan, Peoples R China
[5] Univ British Columbia, BC Childrens Hosp Res Inst, Dept Pediat, Vancouver, BC, Canada
关键词
COVID-19; PJP; Pneumocystis jirovecii; Kidney transplant patient; CARINII-PNEUMONIA;
D O I
10.1186/s12941-021-00489-w
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Background Solid transplant patients are susceptible to Pneumocystis jirovecii pneumonia (PJP). While the vast majority of PJP cases occur within the first 6 months after transplantation, very few PJP cases are seen beyond 1 year post-transplantation (late-onset PJP). PJP and coronavirus disease 2019 (COVID-19, caused by infection with SARS-CoV-2) share quite a few common clinical manifestations and imaging findings, making the diagnosis of PJP often underappreciated during the current COVID-19 pandemic. To date, only 1 case of kidney transplantation who developed COVID-19 and late-onset PJP has been reported, but this patient also suffered from many other infections and died from respiratory failure and multiple organ dysfunction syndrome. A successful treatment of kidney patients with COVID-19 and late-onset PJP has not been reported. Case presentation We present a case of a 55-year-old male kidney transplant patient with COVID-19 who also developed late-onset PJP. He received a combined treatment strategy, including specific anti-pneumocystis therapy, symptomatic supportive therapy, adjusted immunosuppressive therapy, and use of antiviral drugs/antibiotics, ending with a favorable outcome. Conclusions This case highlights the importance of prompt and differential diagnosis of PJP in kidney transplant patients with SARS-CoV-2 infection. Further studies are required to clarify if kidney transplant patients with COVID-19 could be prone to develop late-onset PJP and how these patients should be treated.
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页数:7
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