KIofteridis Diamantis P, Valachis Antonis, Velegraki Maria, Antoniou Maria, Christofaki Maria, Vrentzos George E, Andrianaki Angeliki M, Samonis George
Kansenshogaku Zasshi. 2014 Nov;88(6 Suppl 11):21-5.
Pneumocystisjirovecii (former carinii) pneumonia, is a life-threatening opportunistic infection occurring in immunocompromised hosts. The aim of this study was to investigate the predisposing factors, clinical features and outcome of Pneumocystis pneumonia (PCP) in HIV-negative patients. The medical records of 62 adult patients with PCP, hospitalized at the University Hospital of Heraklion, Crete, Greece during a 10-year period (2004-2013) were retrospectively reviewed. All patients were immunosuppressed prior to the development of PCP. Thirty one patients (50%) suffered malignant hematological disease, 16 (26%) solid tumor and 15 (24%) had chronic inflammatory disease. Only 17 (27%) had received long-term systemic corticosteroids. All had symptoms of pneumonia upon admission, while 12 (19%) were suffering respiratory failure. Twenty one (34%) had received trimethoprim/sulfamethoxazole (TMP-SMX) prophylaxis before the PCP onset. Eight patients (13%) were admitted to the ICU. Mortality attributable to PCP reached 29%. Mortality attributable to PCP was higher in patients with solid tumors. TMP-SMX prophylaxis failed in a significant portion of the present cohort. Hence, PCP should be included in the differential diagnosis in immunocompromised patients with symptoms from the respiratory tract even if TMP-SMX has been given as prophylaxis.
耶氏肺孢子菌（原称卡氏肺孢子菌）肺炎是一种发生于免疫功能低下宿主的危及生命的机会性感染。本研究旨在调查HIV阴性患者发生肺孢子菌肺炎（PCP）的易感因素、临床特征及预后。回顾性分析了希腊克里特岛伊拉克利翁大学医院在10年期间（2004 - 2013年）收治的62例成年PCP患者的病历。所有患者在发生PCP之前均存在免疫抑制。31例患者（50%）患有恶性血液病，16例（26%）患有实体瘤，15例（24%）患有慢性炎症性疾病。只有17例（27%）接受过长期全身性糖皮质激素治疗。所有患者入院时均有肺炎症状，其中12例（19%）出现呼吸衰竭。21例（34%）在PCP发病前接受过甲氧苄啶/磺胺甲恶唑（TMP - SMX）预防治疗。8例患者（13%）入住重症监护病房。PCP导致的死亡率达29%。实体瘤患者中PCP导致的死亡率更高。在本队列中，很大一部分患者TMP - SMX预防治疗失败。因此，即使已给予TMP - SMX进行预防，对于有呼吸道症状的免疫功能低下患者，PCP也应列入鉴别诊断范围。
