An Unusual Case of Cystic Fibrosis Associated Pneumocystis jiroveci Pneumonia in an Infant
Pneumocystis jiroveci pneumonia (PJP) is one of the major infections in patients with impaired immunity. The entity is common in HIV-seropositive individuals but quite very rare in HIV-seronegative individuals especially children. We report here a case of 16-week-old HIV-seronegative infant with chi...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2016/9206707 |
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| author | Ravinder Kaur Priyanka Katariya Megh Singh Dhakad Bhanu Mehra Urmila Jhamb A. P. Dubey |
| author_facet | Ravinder Kaur Priyanka Katariya Megh Singh Dhakad Bhanu Mehra Urmila Jhamb A. P. Dubey |
| author_sort | Ravinder Kaur |
| collection | DOAJ |
| description | Pneumocystis jiroveci pneumonia (PJP) is one of the major infections in patients with impaired immunity. The entity is common in HIV-seropositive individuals but quite very rare in HIV-seronegative individuals especially children. We report here a case of 16-week-old HIV-seronegative infant with chief complaint of chronic cough of one month of evolution. Sweat chloride test for diagnosis of cystic fibrosis was positive. Bronchoalveolar lavage (BAL) fluid was collected and Pseudomonas aeruginosa was isolated on culture. Empirical antibiotic regimen comprising ceftriaxone and azithromycin was initiated that was switched to meropenem as per antimicrobial susceptibility report, but the patient did not improve. Subsequently, an immunofluorescence staining of BAL fluid was performed and P. jiroveci cysts were detected. Following a laboratory confirmation of Pneumocystis pneumonia, cotrimoxazole was added and the clinical condition of the patient significantly improved. This is an unusual case wherein unsuspected PJP occurred and since signs and symptoms of the patient persisted even after the initiation of antimicrobial therapy for Pseudomonas infection and resolved only after treatment for PJP was started, it suggests a causative role of P. jiroveci rather than colonization/contamination. |
| format | Article |
| id | doaj-art-01d2f10a238c4b2a89e95301db29a56f |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-01d2f10a238c4b2a89e95301db29a56f2025-02-03T05:48:25ZengWileyCase Reports in Infectious Diseases2090-66252090-66332016-01-01201610.1155/2016/92067079206707An Unusual Case of Cystic Fibrosis Associated Pneumocystis jiroveci Pneumonia in an InfantRavinder Kaur0Priyanka Katariya1Megh Singh Dhakad2Bhanu Mehra3Urmila Jhamb4A. P. Dubey5Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi 110001, IndiaDepartment of Microbiology, Maulana Azad Medical College and Associated Lok Nayak Hospitals, New Delhi 110002, IndiaDepartment of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi 110001, IndiaDepartment of Microbiology, Maulana Azad Medical College and Associated Lok Nayak Hospitals, New Delhi 110002, IndiaDepartment of Pediatrics, Maulana Azad Medical College and Associated Hospitals, New Delhi 110002, IndiaDepartment of Pediatrics, Maulana Azad Medical College and Associated Hospitals, New Delhi 110002, IndiaPneumocystis jiroveci pneumonia (PJP) is one of the major infections in patients with impaired immunity. The entity is common in HIV-seropositive individuals but quite very rare in HIV-seronegative individuals especially children. We report here a case of 16-week-old HIV-seronegative infant with chief complaint of chronic cough of one month of evolution. Sweat chloride test for diagnosis of cystic fibrosis was positive. Bronchoalveolar lavage (BAL) fluid was collected and Pseudomonas aeruginosa was isolated on culture. Empirical antibiotic regimen comprising ceftriaxone and azithromycin was initiated that was switched to meropenem as per antimicrobial susceptibility report, but the patient did not improve. Subsequently, an immunofluorescence staining of BAL fluid was performed and P. jiroveci cysts were detected. Following a laboratory confirmation of Pneumocystis pneumonia, cotrimoxazole was added and the clinical condition of the patient significantly improved. This is an unusual case wherein unsuspected PJP occurred and since signs and symptoms of the patient persisted even after the initiation of antimicrobial therapy for Pseudomonas infection and resolved only after treatment for PJP was started, it suggests a causative role of P. jiroveci rather than colonization/contamination.http://dx.doi.org/10.1155/2016/9206707 |
| spellingShingle | Ravinder Kaur Priyanka Katariya Megh Singh Dhakad Bhanu Mehra Urmila Jhamb A. P. Dubey An Unusual Case of Cystic Fibrosis Associated Pneumocystis jiroveci Pneumonia in an Infant Case Reports in Infectious Diseases |
| title | An Unusual Case of Cystic Fibrosis Associated Pneumocystis jiroveci Pneumonia in an Infant |
| title_full | An Unusual Case of Cystic Fibrosis Associated Pneumocystis jiroveci Pneumonia in an Infant |
| title_fullStr | An Unusual Case of Cystic Fibrosis Associated Pneumocystis jiroveci Pneumonia in an Infant |
| title_full_unstemmed | An Unusual Case of Cystic Fibrosis Associated Pneumocystis jiroveci Pneumonia in an Infant |
| title_short | An Unusual Case of Cystic Fibrosis Associated Pneumocystis jiroveci Pneumonia in an Infant |
| title_sort | unusual case of cystic fibrosis associated pneumocystis jiroveci pneumonia in an infant |
| url | http://dx.doi.org/10.1155/2016/9206707 |
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