Recurrent Pneumocystis jirovecii pneumonia in an HIV-infected patient: A case report

Nina Dimitrova Tsvetkova; Rumen Nenkov Harizanov; Aleksandra Ivanova Ivanova; Dimitar Todorov Strashimirov; Rusina Stanislavova Grozdeva; Nina Stoyanova Yancheva-Petrova

doi:10.30574/gscarr.2021.7.2.0104

Authors

Nina Dimitrova Tsvetkova National Centre of Infectious and Parasitic Diseases, Department of Parasitology and Tropical Medicine, Sofia, 1504, Bulgaria.
Rumen Nenkov Harizanov National Centre of Infectious and Parasitic Diseases, Department of Parasitology and Tropical Medicine, Sofia, 1504, Bulgaria.
Aleksandra Ivanova Ivanova National Centre of Infectious and Parasitic Diseases, Department of Parasitology and Tropical Medicine, Sofia, 1504, Bulgaria.
Dimitar Todorov Strashimirov Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases (SHATIPD, Department for AIDS, Sofia, 1431, Bulgaria.
Rusina Stanislavova Grozdeva Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases (SHATIPD, Department for AIDS, Sofia, 1431, Bulgaria.
Nina Stoyanova Yancheva-Petrova Medical University-Sofia, Department for Infectious Diseases, Parasitology and Tropical Diseases, Sofia, 1431, Bulgaria.

DOI:

https://doi.org/10.30574/gscarr.2021.7.2.0104

Keywords:

Pneumocystis jirovecii, Pneumocystis pneumonia (PCP), Real-time PCR, Colonization

Abstract

We present a case of Pneumocystis pneumonia (diagnosis was based on imaging X-ray and CAT examinations, and real-time PCR) in an HIV-infected patient with relapse four months later and long lasting colonization as detected by the positive real-time PCR results and lack of clinical symptoms during the follow up of the patient after second course of treatment with trimethoprim/sulfamethoxazole. The wild-type P. jirovecii DHPS genotype was identified in all patient samples tested.

Metrics

Metrics Loading ...

References

Stringer JR, Beard CB, Miller RF, Wakefield AE. A new name (Pneumocystis jirovecii) for Pneumocystis from humans. Emerg. Infect. Dis. 2002; 8: 891–896.

Calderón-Sandubete EJ, Varela-Aguilar JM, Medrano-Ortega FJ, Nieto-Guerrero V, Respaldiza-Salas N, de la Horra-Padilla C, et al. Historical perspective on Pneumocystis carinii infection. Protist. 2002;153: 303–310.

Catherinot E, Lanternier F, Bougnoux M-E, Lecuit M, Couderc L-J, Lortholary O. Pneumocystis jirovecii Pneumonia. Infect. Dis. Clinics of North America. 2010; 24(1): 107–138.

Roux A, Canet E, Valade S, Gangneux-Robert F, Hamane S, Lafabrie A, et al. Pneumocystis jirovecii pneumonia in patients with or without AIDS, France. Emer. Infect. Dis. 2014; 20(9): 1490–1497.

Sepkowitz KA. Opportunistic infections in patients with and patients without acquired immunodeficiency syndrome. Clin. Infect. Dis. 2002; 34: 1098–1107.

Mocroft A, Vella S, Benfield TL, Chiesi A, Miller V, Gargalianos P, et al. Changing patterns of mortality across Europe in patients infected with HIV-1. EuroSIDA Study Group. Lancet. 1998; 352(9142): 1725-1730.

Palella FJ Jr, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection, HIV Outpatient Study Investigators. N. Engl. J. Med. 1998; 338(13): 853-860.

Abgrall S, Matheron S, Le Moing V, Dupont C, Costagliola D. Clinical Epidemiology Group from the French Hospital Database on HIV. Pneumocystis carinii pneumonia recurrence in HIV patients on highly active antiretroviral therapy: secondary prophylaxis. J. Acquir. Immune Defic. Syndr. 2001; 26(2): 151-158.

Calderón E, de la Horra C, Medrano FJ, López-Suárez A, Montes-Cano MA, Respaldiza N, et al. Pneumocystis jiroveci isolates with dihydropteroate synthase mutations in patients with chronic bronchitis. Eur. J. Clin. Microbiol. Infect. Dis. 2004; 23: 545–549.