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Pneumocystis jirovecii pneumonia – An AIDS defining illness?

Abstract number: R2511

Dierkes C., Siebig S., Ehrenstein B., Linde H., Schölmerich J., Salzberger B.

Objective: While HIV patients were known as the most affected collective by Pneumocystis jirovecii (carinii) pneumonia (PcP) in the past, in recent years an increasing number of patients undergoing immunosuppressive therapy or chemotherapy are diagnosed with PcP. Details about the change in epidemiology, the clinical features and the clinical outcome of these patients are little-known.

Methods: Retrospective analysis of all patients diagnosed with PcP at the university medical centre of Regensburg during the years 2004–2007. All patients showed clinical characteristics of PcP and had either microscopically or molecular (PCR) proof of Pneumocystis jirovecii infection.

Results: 67 patients were diagnosed with PcP (49 men, 18 women, median age 52). Underlying disease was mostly malignancy (40%), HIV (27%) and rheumatic disease (15%). Treatment at the intensive care unit was necessary for 42 patients, respiratory therapy for 25 patients. Mortality of the whole group was 27%, considering the different underlying diseases 1 out of 18 HIV patients died while 16 of the 49 other patients did not survive.

Summary: PcP does not seem to be the disease of HIV infected persons any more, as most of the patients in this analysis had different underlying disease. Especially oncologic and rheumatologic cases seem to be a group at risk and PcP should be strongly considered as a differential diagnosis in these patients.

The total mortality of all PcP affected patients in this study was notably higher compared to average mortality rates of HIV patients diagnosed with PcP published in the literature and when comparing the mortality rate of HIV and non-HIV infected patients of our study. Further investigations are needed in order to identify risk factors leading to infection in non-HIV patients and to analyse differences in outcome.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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