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
C2 - 22965844
AN - SCOPUS:84880700959
VL - 19
SP - 342
EP - 347
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
SN - 1341-321X
IS - 2
ER -