[Pneumocystis jiroveci infection associated with organizing pneumonia in a kidney transplant patient].

Abstract

The authors report the association of organizing pneumonia (OP) and a Pneumocystis jiroveci infection in a woman who benefited from a kidney transplant 13 years before and was under corticoids, cyclosporine and mycophenolate mofetil. The diagnosis was based on progressive dyspnoea with fever with an alteration in the general state associated with diffuse micronodular pneumopathy suggesting bronchiolitis. The conformation was obtained by the analysis of the alveolar bronchial washings and the histological examination of the distal biopsies revealing endo-alveolar vegetant fibromas. Transbronchial biopsies may be used for the diagnosis and thereby, avoid an invasive surgical pulmonary biopsy. The aetiology of OP may be related to the immunosuppressant treatment or infection by Pneumocystis jiroveci. The evolution in this case was favourable with trimethoprime and sulfamethoxazole associated with a transient increase in the corticoid treatment. This association is rarely described in patients undergoing solid organ transplants.

• Authors: B Camara, G Martin-Blondel, L Desloques, A Ould Mohamed, I Rouquette, C Hermant, L Rostaing, N Kamar
• Journal: Revue de pneumologie clinique (Rev Pneumol Clin) Vol. 66 Issue 6 Pg. 347-50 (Dec 2010) ISSN: 1776-2561 [Electronic] France
• Vernacular Title: Infection à Pneumocystis jiroveci associée à une pneumopathie organisée chez une patiente transplantée rénale.
• PMID: 21167442 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2009 Elsevier Masson SAS. All rights reserved.

Chemical References

• Immunosuppressive Agents

Topics

• Biopsy
• Bronchoscopy
• Cryptogenic Organizing Pneumonia (diagnosis, pathology)
• Diagnosis, Differential
• Drug Therapy, Combination
• Female
• Humans
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Kidney Transplantation (immunology)
• Lung (pathology)
• Middle Aged
• Opportunistic Infections (diagnosis, pathology)
• Pneumocystis carinii
• Pneumonia, Pneumocystis (diagnosis, pathology)
• Postoperative Complications (diagnosis)
• Pulmonary Alveoli (pathology)
• Tomography, X-Ray Computed