Zhang Zhijuan, Zheng Hong, Wang Shengfeng, Zhu Shan, Yang Minghua
Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha 410013.
Department of Pharmacy, Third Xiangya Hospital, Central South University, Changsha 410013, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2025 Jun 28;50(6):1106-1112. doi: 10.11817/j.issn.1672-7347.2025.240433.
pneumonia (PJP) is an opportunistic pulmonary infection that commonly occurs in immunocompromised children. We report a case of infantile leukemia complicated by PJP and review the relevant literature. A summary and analysis of 10 infantile leukemia patients with PJP infection (9 cases reported in the literature and 1 case from our center) showed that PJP mostly occurred in the early stages of chemotherapy (80%, 8/10). The main clinical manifestations were dyspnea (100%, 10/10) and hypoxemia (50%, 5/10), while pulmonary imaging findings lacked specificity. In most cases (50%, 5/10), diagnosis was established by identifying pathogens in bronchoalveolar lavage fluid under microscopy. In our case, diagnosis was confirmed using targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid. Treatment with intravenous sulfamethoxazole complex was administered in 8 patients, all of whom eventually recovered. PJP may occur in the early stages of chemotherapy for infantile leukemia, thus early prevention is necessary. tNGS facilitates early diagnosis of PJP, and sulfamethoxazole complex remains an effective therapeutic option.
肺孢子菌肺炎(PJP)是一种机会性肺部感染,常见于免疫功能低下的儿童。我们报告一例婴儿白血病合并PJP的病例并复习相关文献。对10例婴儿白血病合并PJP感染患者(9例文献报道病例及1例本中心病例)的总结分析显示,PJP大多发生在化疗早期(80%,8/10)。主要临床表现为呼吸困难(100%,10/10)和低氧血症(50%,5/10),而肺部影像学表现缺乏特异性。大多数病例(50%,5/10)通过显微镜下在支气管肺泡灌洗液中鉴定病原体确诊。在我们的病例中,通过支气管肺泡灌洗液的靶向二代测序(tNGS)确诊。8例患者接受静脉复方磺胺甲恶唑治疗,所有患者最终均康复。PJP可能发生在婴儿白血病化疗早期,因此早期预防很有必要。tNGS有助于PJP的早期诊断,复方磺胺甲恶唑仍然是一种有效的治疗选择。