Pneumocystis jirovecii Pneumonia and Alveolar Hemorrhage in a Pregnant Woman with Human T Cell Lymphotropic Virus Type-1 Infection

Tamaki, Yuko; Higa, Futoshi; Tasato, Daisuke; Nakamura, Hideta; Uechi, Kayoko; Tamayose, Maki; Haranaga, Shusaku; Yara, Satomi; Tateyama, Masao; Fujita, Jiro

doi:10.2169/internalmedicine.50.4482

Cited by 6 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In fact, patients with IPF showed a significantly higher density of hemosiderin-laden macrophages in their BAL fluids than healthy smokers [11]. Previous studies on lung disease have reported cases of alveolar hemorrhage in patients with druginduced lung injury, pneumocystis pneumonia, and influenza viral infection [12][13][14]. Maldonado et al reported that one-third of the patients surgically proven to have diffuse alveolar damage showed BAL fluids consisting of ≥20% hemosiderin-laden macrophages [15].…”

Section: Discussionmentioning

confidence: 99%

Anticoagulant Use as an Independent Risk Factor and Higher In-Hospital Mortality in Patients Showing Alveolar Hemorrhage in Diffuse Lung Disease

2021

View full text Add to dashboard Cite

Background and objectives: Bronchoalveolar lavage (BAL) is commonly performed to evaluate diffuse lung disease and occasionally to identify alveolar hemorrhage. However, the clinical impact of alveolar hemorrhage and its risk factors in patients with diffuse lung disease have not been clarified. Materials and Methods: We retrospectively analyzed the medical records of all patients who underwent BAL to evaluate diffuse lung disease from January 2017 to December 2020. Alveolar hemorrhage was defined as progressive hemorrhagic BAL fluid or the presence of ≥20% hemosiderin-laden macrophages in the BAL fluid. Logistic regression analysis was performed to assess the association between alveolar hemorrhage and other factors. Results: Sixty subjects were enrolled in this study. Alveolar hemorrhage was observed in 19 subjects (31.7%) with idiopathic interstitial pneumonia, acute respiratory distress syndrome, interstitial pneumonia with autoimmune features, drug-induced lung injury, eosinophilic pneumonia, adenocarcinoma, and systemic lupus erythematosus. The use of anticoagulants was a significant risk factor for alveolar hemorrhage (odds ratio 7.57, p = 0.049). Patients with alveolar hemorrhage required intubated mechanical ventilation more frequently (63.2% vs. 24.4%, p = 0.005) and had higher in-hospital mortality rates (26.3% vs. 4.9%, p = 0.028) than those without alveolar hemorrhage. Conclusions: Alveolar hemorrhage was observed in various etiologies. The use of anticoagulants was a significant risk factor for alveolar hemorrhage. Patients with alveolar hemorrhage showed more severe respiratory failure and had higher in-hospital mortality than those without alveolar hemorrhage.

show abstract

Section: Discussionmentioning

confidence: 99%

Anticoagulant Use as an Independent Risk Factor and Higher In-Hospital Mortality in Patients Showing Alveolar Hemorrhage in Diffuse Lung Disease

2021

View full text Add to dashboard Cite

show abstract

“…However, our cases are extremely rare in that both occurred in pregnant women without HIV. To the best of our knowledge, only one similar case of PCP has been reported thus far, and, in that case, PCP developed in a pregnant woman who was infected with human T lymphotropic virus type 1 (HTLV-1) [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Pneumocystis Pneumonia in Non-HIV Pregnant Women Receiving Chemotherapy for Malignant Lymphoma: Two Case Reports

Fukutani

Chigusa

Kondoh

et al. 2017

Case Reports in Obstetrics and Gynecology

View full text Add to dashboard Cite

Pneumocystis pneumonia (PCP) is a life-threatening opportunistic infection that sometimes occurs in immunocompromised patients with human immunodeficiency virus (HIV). Here, we report two extremely rare cases of PCP in non-HIV pregnant women who underwent chemotherapy for malignant lymphoma. Case 1 is a 34-year-old primigravida who was diagnosed with Hodgkin's lymphoma. She received ABVD chemotherapy and developed PCP at 37 weeks of gestation. After the onset of PCP, emergent cesarean section was performed due to a nonreassuring fetal status. Case 2 is a 31-year-old multigravida with diffuse large B-cell lymphoma who was administered R-CHOP chemotherapy. At 34 weeks of gestation, she complained of dyspnea and developed PCP. She delivered her baby vaginally immediately after the onset of symptoms. Both patients were treated with sulfamethoxazole-trimethoprim (ST) and recovered shortly thereafter. The babies' courses were also uneventful. PCP remains a serious cause of death, especially in non-HIV patients, and, therefore, appropriate prophylaxis and a prompt diagnosis are imperative.

show abstract

“…2 Acute lung injury during pregnancy results in high morbidity and mortality for both the mother and the fetus. 3 In the USA, Pneumocystis carinni pneumonia is the most common cause of AIDS-related death in pregnant women. 4 Many HIV-infected persons in the USA remain at high risk of opportunistic infection because they are unaware of their HIV infection.…”

Section: Introductionmentioning

confidence: 99%

Pneumocystis Carinii Pneumonia; Lost Lives in Pregnancy: Chemoprophylaxis Saves Lives

Ngwenya¹

2017

Pulm Res Respir Med Open J

View full text Add to dashboard Cite

The advent of HIV/AIDS brought opportunistic infections such as Pneumocystis jiroveci pneumonia (PJP), formerly known as Pneumocystis carinii pneumonia (PCP) to the fore. This is a fungal opportunistic infection that is an human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) defining illness. It poses significant risks to both the mother and the fetus. Pneumocystis carinii pneumonia can have a sub-clinical insidious onset but can rapidly progress to acute respiratory failure leading to maternal and fetal demise. The best form of management of pneumocystis carinii pneumonia is prevention. Widespread chemoprophylaxis with co-trimoxazole reduces morbidity and mortality. The management calls for a multidisciplinary approach involving the physician, obstetrician and pneumologist. Pneumocystis carinii pneumonia has a more aggressive course during pregnancy with increased morbidity and mortality, maternal and fetal outcomes remaining dismal. Therefore, it is important that widespread HIV testing and use of co-trimoxazole chemoprophylaxis are made readily available to reduce morbidity and mortality. It must be a differential diagnosis of any pregnant HIV seropositive patient presenting with pulmonary symptomatology.

show abstract

Pneumocystis jirovecii Pneumonia and Alveolar Hemorrhage in a Pregnant Woman with Human T Cell Lymphotropic Virus Type-1 Infection

Cited by 6 publications

References 11 publications

Anticoagulant Use as an Independent Risk Factor and Higher In-Hospital Mortality in Patients Showing Alveolar Hemorrhage in Diffuse Lung Disease

Anticoagulant Use as an Independent Risk Factor and Higher In-Hospital Mortality in Patients Showing Alveolar Hemorrhage in Diffuse Lung Disease

Pneumocystis Pneumonia in Non-HIV Pregnant Women Receiving Chemotherapy for Malignant Lymphoma: Two Case Reports

Pneumocystis Carinii Pneumonia; Lost Lives in Pregnancy: Chemoprophylaxis Saves Lives

Contact Info

Product

Resources

About