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A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection

Year 2019, Volume: 11 Issue: 2, 325 - 328, 28.06.2019
https://doi.org/10.18521/ktd.423555

Abstract

Pneumocystis jirovecii pneumonia (commonly called Pneumocystis pneumonia or PCP) is an opportunistic infection that occurs in immunocompromised individuals.  26 year-old male patient admitted to nephrology department for hypervolemic hyponatremia and consulted to our clinic because  desaturation developed. He has been diagnosed with collapsing glomerulonephritis (GN) and he was using cyclosporine and prednisolone. Postero-anterior chest X-ray  showed that; left cardiodiaphragmatic sinus was blunt. In the arterial blood gas, Ph:7,42  PO2:53 mmHg PCO2:35,4 mmHg, HCO3:23,6 mEql/L. The the alveolar arterial gradient was elevated (52,75). Antibiotic and because of hypervolemia diuretic therapy was recommended to the patient. After ten days the patient's hypoxia deepened.Repeated chest X-ray showed bilateral perihilar  heterogeneous opacity.  Flexible bronchoscopy was performed. Pneumocystis jirovecii was detected in lavage culture. The patient treated with Trimethoprim- Sulfamethoxazole (TMP-SMZ) (3 x 7.5 mg / kg) dose. Hypoxemia improved on the 7th day of treatment and the patient was discharged. TMP-SMZ treatment was completed in 21 days. Pneumocystis developing secondary to cyclosporin toxicity Jirovecii pneumonia is a rare case. 



References

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Pnömosistis Jirovecii Enfeksiyonu Tanısı Alan Nefrotik Sendrom Olgusu

Year 2019, Volume: 11 Issue: 2, 325 - 328, 28.06.2019
https://doi.org/10.18521/ktd.423555

Abstract

References

  • 1. Töz S, Gündüz C, Tetik A, Taşbakan M, Pullukçu H, Bacakoğlu F, Taşbakan MS, Gülen F, Ünver A, Turgay N. The comparison of microscopy and real time polymerase chain reaction methods for the diagnosis of Pneumocystis Jirovecii pneumonia: evaluation of clinical parameters. Tuberk Toraks 2017;65(3):220-226.
  • 2. Prasad P, Lo KB, Ram P. Late presentation of Pneumocystis jirovecii pneumonia after renal transplant: A case report. Med Mycol Case Rep. 2018 Jun; 20: 33–34.
  • 3. Block BL, Mehta T, Ortiz GM, Ferris SP, Vu TH, Huang L, Cattamanchi A. Unusual Radiographic Presentation of Pneumocystis Pneumonia in a Patient with AIDS. Case Rep Infect Dis. 2017; 2017: 3183525.
  • 4. Carmona EM, Limper AH. Update on the diagnosis and treatment of Pneumocystis pneumonia. Ther Adv Respir Dis. 2011 Feb;5(1):41-59.
  • 5. Yale SH, Limper AH: Pneumocystis carinii pneumonia in patients without acquired immunodeficiency syndrome: associated illnesses and prior corticosteroid therapy. Mayo Clin Proc 1996;71:5-13.
  • 6. Hui M, Kwok WT. Pneumocystis carinii pneumonia in Hong Kong: a 10 year retrospective study, Journal of Medical Microbiology (2006), 55, 85–88
  • 7. Wilkin A, Feinberg J. Pneumocystis carinii Pneumonia: A Clinical Review. American Family Physician. October 15, 1999.
  • 8. Ebner L, Walti LN, Rauch A, Furrer H, Cusini A, Meyer AM, Weiler S, Huynh-Do U, Heverhagen J, Arampatzis S, Christe A. Clinical Course, Radiological Manifestations, and Outcome of Pneumocystis jirovecii Pneumonia in HIV Patients and Renal Transplant Recipients. PLoS One. 2016; 11(11): e0164320.
  • 9. The Korean Society for AIDS. The 2015 Clinical Guidelines for the Treatment and Prevention of Opportunistic Infections in HIV-Infected Koreans: Guidelines for Opportunistic Infections. Infect Chemother. 2016 Mar; 48(1): 54–60.10. Matthew B. Smith, .Stephen B. Hanauer, . Pneumocytis Carinii Pneumonia During Cyclosporine Therapy For Ulcerative Colitis N Engl J Med 1992; 327:497-498
There are 9 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Reports
Authors

Merve Erçelik

Gül Akın This is me

Kürşad Öneç

Fuat Aytekin This is me

Özlem Ataoğlu This is me

Mehmet Fatih Elverişli

Publication Date June 28, 2019
Acceptance Date June 12, 2019
Published in Issue Year 2019 Volume: 11 Issue: 2

Cite

APA Erçelik, M., Akın, G., Öneç, K., Aytekin, F., et al. (2019). A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection. Konuralp Medical Journal, 11(2), 325-328. https://doi.org/10.18521/ktd.423555
AMA Erçelik M, Akın G, Öneç K, Aytekin F, Ataoğlu Ö, Elverişli MF. A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection. Konuralp Medical Journal. June 2019;11(2):325-328. doi:10.18521/ktd.423555
Chicago Erçelik, Merve, Gül Akın, Kürşad Öneç, Fuat Aytekin, Özlem Ataoğlu, and Mehmet Fatih Elverişli. “A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection”. Konuralp Medical Journal 11, no. 2 (June 2019): 325-28. https://doi.org/10.18521/ktd.423555.
EndNote Erçelik M, Akın G, Öneç K, Aytekin F, Ataoğlu Ö, Elverişli MF (June 1, 2019) A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection. Konuralp Medical Journal 11 2 325–328.
IEEE M. Erçelik, G. Akın, K. Öneç, F. Aytekin, Ö. Ataoğlu, and M. F. Elverişli, “A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection”, Konuralp Medical Journal, vol. 11, no. 2, pp. 325–328, 2019, doi: 10.18521/ktd.423555.
ISNAD Erçelik, Merve et al. “A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection”. Konuralp Medical Journal 11/2 (June 2019), 325-328. https://doi.org/10.18521/ktd.423555.
JAMA Erçelik M, Akın G, Öneç K, Aytekin F, Ataoğlu Ö, Elverişli MF. A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection. Konuralp Medical Journal. 2019;11:325–328.
MLA Erçelik, Merve et al. “A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection”. Konuralp Medical Journal, vol. 11, no. 2, 2019, pp. 325-8, doi:10.18521/ktd.423555.
Vancouver Erçelik M, Akın G, Öneç K, Aytekin F, Ataoğlu Ö, Elverişli MF. A Case of Nephrotic Syndrome With Pneumocystis Jirovecii Infection. Konuralp Medical Journal. 2019;11(2):325-8.