Wang Xiaoning, Li Hao, Li Jing, Zhang Mei, He Pengcheng
Department of Hematology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Intensive Care Unit, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
Int Immunopharmacol. 2023 Feb;115:109636. doi: 10.1016/j.intimp.2022.109636. Epub 2022 Dec 28.
Pneumocystis jiroveci Pneumonia (PCP) is a common cause of opportunistic lung infection and is associated with high mortality in immunocompromised patients. Few reports describe pneumocystis jiroveci as a causative agent of tyrosine kinase inhibitor or blinatumomab related infections. Case presentation A 64-year-old man with philadelphia chromosome positive acute lymphoblastic leukemia (ALL) presented to the intensive care unit with intermittent high fever and shortness of breath. Three cycles of tyrosine kinase inhibitor (TKI) with blinatumomab therapy were given in recent 4 months. Next-generation sequencing of bronchoalveolar lavage fluid and peripheral blood showed pneumocystis jiroveci. After trimethoprim- sulfamethoxazole treatment and subsequent mechanical ventilation, the infection was controlled successfully.
Due to susceptibility and early onset of PCP in ALL patients received TKI combined with blinatumomab therapy, so we should be alert to PCP when pulmonary infection occurred.
耶氏肺孢子菌肺炎（PCP）是机会性肺部感染的常见原因，在免疫功能低下患者中死亡率较高。很少有报告将耶氏肺孢子菌描述为酪氨酸激酶抑制剂或博纳吐单抗相关感染的病原体。病例报告：一名64岁费城染色体阳性急性淋巴细胞白血病（ALL）男性因间歇性高热和呼吸急促入住重症监护病房。最近4个月内接受了三个周期的酪氨酸激酶抑制剂（TKI）联合博纳吐单抗治疗。支气管肺泡灌洗液和外周血的二代测序显示为耶氏肺孢子菌。经甲氧苄啶-磺胺甲恶唑治疗及随后的机械通气，感染得到成功控制。
由于接受TKI联合博纳吐单抗治疗的ALL患者对PCP易感且发病早，因此当发生肺部感染时应警惕PCP。
