Abstract
A 95-year-old man with chronic obstructive pulmonary disease and chronic hepatitis C virus infection was treated for acute lung injury caused by Chlamydophila pneumoniae with antibiotics and high-dose corticosteroids. In total, 7,500 mg methylprednisolone and 680 mg prednisolone were administered over 21 days. However, respiratory failure progressed, and chest computed tomography (CT) scan showed bilateral ground-glass opacity and cavity-forming consolidation in the right upper lobe. Despite intensive therapy, the patient died of multiple organ failure on day 7. CT-guided necropsy was performed, and pathological examination revealed invasive pulmonary aspergillosis and Pneumocystis jirovecii pneumonia. Invasive pulmonary aspergillosis and P. jirovecii pneumonia are both life-threatening opportunistic fungal infections. Co-infection of these organisms is rare but possible if the patient is in an extremely immunocompromised state. Short-term but high-dose systemic corticosteroid therapy was considered to be the risk factor in this case. We should pay more attention to immunocompromised hosts who might be suffering from co-infection of opportunistic infections. Moreover, we need to consider preventive measures in such high-risk cases.
| Original language | English |
|---|---|
| Pages (from-to) | 342-347 |
| Number of pages | 6 |
| Journal | Journal of Infection and Chemotherapy |
| Volume | 19 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Apr 2013 |
| Externally published | Yes |
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Keywords
- Coinfection
- Corticosteroid therapy
- Invasive pulmonary aspergillosis
- Opportunistic infection
- Pneumocystis jirovecii pneumonia
ASJC Scopus subject areas
- Microbiology (medical)
- Pharmacology (medical)
- Infectious Diseases
Cite this
Co-infection with invasive pulmonary aspergillosis and Pneumocystis jirovecii pneumonia after corticosteroid therapy. / Hagiya, Hideharu; Miyake, Takayoshi; Kokumai, Yusuke; Murase, Tomoko; Kuroe, Yasutoshi; Nojima, Hiroyoshi; Sugiyama, Junichi; Naito, Hiromichi; Hagioka, Shingo; Morimoto, Naoki.
In: Journal of Infection and Chemotherapy, Vol. 19, No. 2, 04.2013, p. 342-347.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Co-infection with invasive pulmonary aspergillosis and Pneumocystis jirovecii pneumonia after corticosteroid therapy
AU - Hagiya, Hideharu
AU - Miyake, Takayoshi
AU - Kokumai, Yusuke
AU - Murase, Tomoko
AU - Kuroe, Yasutoshi
AU - Nojima, Hiroyoshi
AU - Sugiyama, Junichi
AU - Naito, Hiromichi
AU - Hagioka, Shingo
AU - Morimoto, Naoki
PY - 2013/4
Y1 - 2013/4
N2 - A 95-year-old man with chronic obstructive pulmonary disease and chronic hepatitis C virus infection was treated for acute lung injury caused by Chlamydophila pneumoniae with antibiotics and high-dose corticosteroids. In total, 7,500 mg methylprednisolone and 680 mg prednisolone were administered over 21 days. However, respiratory failure progressed, and chest computed tomography (CT) scan showed bilateral ground-glass opacity and cavity-forming consolidation in the right upper lobe. Despite intensive therapy, the patient died of multiple organ failure on day 7. CT-guided necropsy was performed, and pathological examination revealed invasive pulmonary aspergillosis and Pneumocystis jirovecii pneumonia. Invasive pulmonary aspergillosis and P. jirovecii pneumonia are both life-threatening opportunistic fungal infections. Co-infection of these organisms is rare but possible if the patient is in an extremely immunocompromised state. Short-term but high-dose systemic corticosteroid therapy was considered to be the risk factor in this case. We should pay more attention to immunocompromised hosts who might be suffering from co-infection of opportunistic infections. Moreover, we need to consider preventive measures in such high-risk cases.
AB - A 95-year-old man with chronic obstructive pulmonary disease and chronic hepatitis C virus infection was treated for acute lung injury caused by Chlamydophila pneumoniae with antibiotics and high-dose corticosteroids. In total, 7,500 mg methylprednisolone and 680 mg prednisolone were administered over 21 days. However, respiratory failure progressed, and chest computed tomography (CT) scan showed bilateral ground-glass opacity and cavity-forming consolidation in the right upper lobe. Despite intensive therapy, the patient died of multiple organ failure on day 7. CT-guided necropsy was performed, and pathological examination revealed invasive pulmonary aspergillosis and Pneumocystis jirovecii pneumonia. Invasive pulmonary aspergillosis and P. jirovecii pneumonia are both life-threatening opportunistic fungal infections. Co-infection of these organisms is rare but possible if the patient is in an extremely immunocompromised state. Short-term but high-dose systemic corticosteroid therapy was considered to be the risk factor in this case. We should pay more attention to immunocompromised hosts who might be suffering from co-infection of opportunistic infections. Moreover, we need to consider preventive measures in such high-risk cases.
KW - Coinfection
KW - Corticosteroid therapy
KW - Invasive pulmonary aspergillosis
KW - Opportunistic infection
KW - Pneumocystis jirovecii pneumonia
UR - http://www.scopus.com/inward/record.url?scp=84880700959&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880700959&partnerID=8YFLogxK
U2 - 10.1007/s10156-012-0473-9
DO - 10.1007/s10156-012-0473-9
M3 - Article
VL - 19
SP - 342
EP - 347
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
SN - 1341-321X
IS - 2
ER -