NDLI: Pneumocystis jiroveci pneumonia in immunocompromised patients: delayed diagnosis and poor outcomes in non-HIV-infected individuals.

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Pneumocystis jiroveci pneumonia in immunocompromised patients: delayed diagnosis and poor outcomes in non-HIV-infected individuals.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Li, Ming-Chi Lee, Nan-Yao Lee, Ching-Chi Lee, Hsin-Chun Chang, Chia-Ming Ko, Wen-Chien
Spatial Coverage	Taiwan
Description	Country affiliation: Taiwan Author Affiliation: Li MC ( Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan.); Lee NY ( Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan.); Lee CC ( Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan.); Lee HC ( Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan.); Chang CM ( Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan.); Ko WC ( Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan, Taiwan. Electronic address: winston3415@gmail.com.)
Abstract	BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) is a life-threatening disease in immunocompromised patients. Improved knowledge about the varied characteristics and management in different populations may guide treatment. METHODS: We evaluated the clinical characteristics, management, and outcomes of patients with PJP diagnosed by nested polymerase chain reaction at a medical center in southern Taiwan from 2008 to 2011. The risk factors of mortality among non-human immunodeficiency virus (HIV)-infected patients were analyzed. RESULTS: During the study period, there were 43 cases of PJP, and the common underlying diseases were HIV infection (23 patients, median CD4 count: 19/µl) and malignancy. The HIV-infected patients had a younger age (36.9 ± 13.7 vs. 50.2 ± 16.2 years, p = 0.006), a lower body mass index (19.9 ± 2.3 vs. 22.0 ± 3.7 kg/m(2), p = 0.035), a longer duration of symptoms before admission (24 ± 29 vs. 7 ± 15 days, p = 0.035), and a lower pneumonia severity index (56 ± 25 vs. 99 ± 35, p < 0.001) than non-HIV-infected patients. A delay between admission and starting antimicrobial therapy for PJP (10 ± 10 days vs. 1 ± 3 days, p = 0.004) and a high crude mortality (12/20, 60% vs. 2/23, 9%, p = 0.001) were noted in non-HIV-infected patients. In the univariate analysis, the risk factors for mortality were a low lymphocyte count (p < 0.05) and shock during hospitalization (p = 0.004). CONCLUSION: A delay in the initiation of antimicrobial therapy for PJP and severe pneumonia were more common in the non-HIV-infected patients and were most likely related to the poor prognosis. The utilization of sensitive diagnostic tools to facilitate early diagnosis and treatment may improve the clinical outcomes of non-HIV-infected patients with PJP.
File Format	HTM / HTML
ISSN	16841182
e-ISSN	19959133
Journal	Journal of Microbiology, Immunology and Infection
Issue Number	1
Volume Number	47
Language	English
Publisher	Elsevier
Publisher Date	2014-02-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Microbiology Discipline Immunology Delayed Diagnosis Immunocompromised Host Pneumocystis Carinii Isolation & Purification Pneumonia, Pneumocystis Diagnosis Drug Therapy Mortality Prognosis Risk Factors Survival Analysis Taiwan Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Immunology and Microbiology Immunology and Allergy Microbiology (medical)

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