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[Pneumocystis jiroveci pneumonia during prolonged corticosteroid therapy in an immunocompetent infant]

N Guillemot1, S Blanchon, N Nathan

  • 1Unité de pneumologie pédiatrique, hôpital d'Enfants Armand-Trousseau, AP-HP, 26, avenue du Dr-Netter, 75571 Paris cedex 12, France.

Revue De Pneumologie Clinique
|November 11, 2008
PubMed

Insights

Pneumocystis jiroveci (PJ) pneumonia is rare in infants but can be severe. This case highlights the risk in immunocompetent infants after prolonged corticosteroid use, emphasizing prompt diagnosis and treatment.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Immunology

Background:

  • Pneumocystis jiroveci (PJ) infection is uncommon in infants and often indicates underlying immunodeficiency.
  • Prolonged corticosteroid therapy can increase susceptibility to opportunistic infections, even in seemingly immunocompetent individuals.

Observation:

  • A 5.5-month-old infant presented with severe hypoxemic respiratory distress.
  • The infant had a history of prolonged oral corticosteroid treatment for a parotid hemangioma.
  • Chest X-ray revealed a mixed alveolar-interstitial pattern, and bronchoalveolar lavage confirmed PJ presence.

Findings:

  • The infant was diagnosed with severe Pneumocystis jiroveci pneumonia.
  • Treatment with intravenous trimethoprim-sulfamethoxazole resulted in a favorable outcome after three weeks.

Implications:

  • PJ pneumonia should be suspected in infants with progressive respiratory distress and a mixed alveolar-interstitial pattern on chest imaging.
  • Prophylactic therapy is crucial for infants undergoing prolonged immunosuppressive treatments, including chemotherapy and corticosteroid therapy, to prevent severe infections.
Abstract

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