J Korean Soc Transplant.  2015 Dec;29(4):242-246. 10.4285/jkstn.2015.29.4.242.

Late Onset Infection of Pneumocystis jirovecii Infection in a Renal Transplant Recipient

Affiliations
  • 1Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea. kidney119@hotmail.com

Abstract

Pneumocystis jirovecii pneumonia (PCP) can be a life-threatening opportunistic infection after kidney transplantation, occurring most frequently in the first 12 months with the symptoms of dyspnea, cough, fever, and hypoxia. Prophylaxis for PCP is usually applied during the first 3 months to 1 year after transplantation, but late onset incidence of PCP can be detected. We report on a patient who developed PCP 9 years after renal transplantation. The patient showed indolent onset of acute respiratory distress and was treated with trimethoprim-sulfamethoxazole and corticosteroid therapy. Previous rescue treatment of acute cellular rejection with ongoing maintenance of an elevated level of immunosuppressants may have predisposed the patient to PCP.

Keyword

Kidney transplantation; Pneumonia; Pneumocystis jirovecii; infection

MeSH Terms

Anoxia
Cough
Dyspnea
Fever
Humans
Immunosuppressive Agents
Incidence
Kidney Transplantation
Opportunistic Infections
Pneumocystis jirovecii*
Pneumocystis*
Pneumonia
Transplantation*
Trimethoprim, Sulfamethoxazole Drug Combination
Immunosuppressive Agents

Figure

  • Fig. 1. (A) On admission day, chest posteroanterior (PA) shows diffusely increased density in both lower lung zone. (B) After 3 weeks, diffuse opacities is not seen in chest PA.

  • Fig. 2. (A) High resolution computed tomography (HRCT) on admission shows diffuse ground glass opacity (GGO) of lower lung predominance. (B) After 8 days, HRCT shows more aggravated lesions. (C) HRCT on day 21 shows a dramatic regression of the GGO after treatment.


Reference

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