Intermittent Courses of Corticosteroids Also Present a Risk for Pneumocystis Pneumonia in Non-HIV Patients
| Autor: | Eva M. Carmona, Isabel Martin-Garrido, Andrew H. Limper, Mikel Donazar-Ezcurra, Maria L. Calero-Bernal |
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| Přispěvatelé: | [Calero-Bernal, Maria L.] Mayo Clin, Div Pulm & Crit Care, Dept Med, Rochester, MN 55902 USA, [Martin-Garrido, Isabel] Mayo Clin, Div Pulm & Crit Care, Dept Med, Rochester, MN 55902 USA, [Donazar-Ezcurra, Mikel] Mayo Clin, Div Pulm & Crit Care, Dept Med, Rochester, MN 55902 USA, [Limper, Andrew H.] Mayo Clin, Div Pulm & Crit Care, Dept Med, Rochester, MN 55902 USA, [Carmona, Eva M.] Mayo Clin, Div Pulm & Crit Care, Dept Med, Rochester, MN 55902 USA, [Calero-Bernal, Maria L.] Hosp Univ Virgen del Rocio, Med Interna Serv, Seville, Spain, [Martin-Garrido, Isabel] Hosp Quiron San Camilo, Med Interna Serv, Madrid, Spain, [Donazar-Ezcurra, Mikel] Complejo Hosp Navarra, Pamplona, Navarra, Spain, National Institutes of Health, Annenberg Foundation, Servicio de Medicina Interna, Hospital Universitario Virgen del Rocio, Seville, Spain |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Article Subject Population B-cells Pneumocystis pneumonia law.invention 03 medical and health sciences Diseases of the respiratory system Adjunctive corticosteroids 0302 clinical medicine law Internal medicine medicine Innate 030212 general & internal medicine Intensive care medicine education Cancer Carinii-pneumonia education.field_of_study Clinical characteristics RC705-779 business.industry Incidence (epidemiology) Polymerase-chain-reaction Retrospective cohort study medicine.disease Intensive care unit 3. Good health Respiratory-failure Pneumonia 030228 respiratory system Chemoprophylaxis Jiroveci pneumonia Coinfection Infection business |
| Zdroj: | Canadian Respiratory Journal, Vol 2016 (2016) |
| ISSN: | 1198-2241 |
| DOI: | 10.1155/2016/2464791 |
| Popis: | Introduction.Pneumocystispneumonia (PCP) is rising in the non-HIV population and associates with higher morbidity and mortality. The aggressive immunosuppressive regimens, as well as the lack of stablished guidelines for chemoprophylaxis, are likely contributors to this increased incidence. Herein, we have explored the underlying conditions, immunosuppressive therapies, and clinical outcomes of PCP in HIV-negative patients.Methods. Retrospective analysis of PCP in HIV-negative patients at Mayo Clinic from 2006–2010. The underlying condition, immunosuppressive therapies, coinfection, and clinical course were determined. PCP diagnosis required symptoms of pneumonia and identification of the organisms by visualization or by a real-time polymerase chain reaction.Results. A total of 128 cases of PCP were identified during the study period. Hematological malignancies were the predisposing condition for 50% of the patients. While 87% had received corticosteroids or other immunosuppressive therapies for >4 weeks prior to the diagnosis, only 7 were receiving PCP prophylaxis. Up to 43% of patients were not on daily steroids. Sixty-seven patients needed Intensive Care Unit (ICU) and 53 received mechanical ventilation. The mortality for those patients requiring ICU was 40%.Conclusions. PCP diagnosis in the HIV-negative population requires a high level of suspicion even if patients are not receiving daily corticosteroids. Mortality remains high despite adequate treatment. |
| Databáze: | OpenAIRE |
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