Pneumocystis Pneumonia in a Patient with Type 2 Diabetes Mellitus

Sanno, Ken; Hatanaka, Nobuyuki; Yamagishi, Toshiyuki; Kamemura, Hirotaka; Hirano, Yusuke; Kodaka, Norio; Miura, Atsuo; Kitahara, Ayao; Sawata, Tetsuro; Hosaka, Kimio; Nakazawa, Ichiro

doi:10.2169/internalmedicine.46.0011

Cited by 4 publications

(7 citation statements)

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“…Patients with malignancies, solid organ transplant recipients and patients treated by immunosuppressive agents are susceptible to this infection [5, 6, 7-13]. In addition, some other conditions such as diabetes and severe malnutrition increase the risk of PCP [14, 15]. …”

Section: Introductionmentioning

confidence: 99%

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Molecular detection of Pneumocystis jirovecii using polymerase chain reaction in immunocompromised patients with pulmonary disorders in northeast of Iran

et al. 2015

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Background and Purpose:Pneumocystis pneumonia, caused by Pneumocystis jirovecii, is a fatal disease threatening patients with AIDS or immunosuppression. Assessment of colonization in these patients is of great significance, since it can lead to severe pulmonary disorders. Considering the scarcity of published reports on Pneumocystis jirovecii isolates from patients in Mashhad, Iran, we aimed to evaluate pneumocystis colonization in individuals with different pulmonary disorders.Materials and Methods:We used nested polymerase chain reaction (PCR) method to amplify mitochondrial large subunit-ribosomal ribonucleic acid (mtLSU-rRNA) gene in 60 bronchoalveolar lavage (BAL) samples, obtained from patients, referring to the Department of Internal Medicine (Pulmonary Diseases Section) at Imam Reza Hospital, affiliated to Mashhad University of Medical Sciences, Mashhad, Iran. Results:DNA of Pneumocystis jirovecii was detected in 10 out of 60 BAL samples (16.66%) via nested PCR method.Conclusion:According to the present findings, the colonization rate of Pneumocystis jirovecii was similar to the rates reported in other similar studies in Iran.

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Section: Introductionmentioning

confidence: 99%

“…Since colonization of the pulmonary tract with this fungus may promote the risk of infection, evaluation of colonization rate in immunocompromised patients is essential [14, 15]. …”

Section: Introductionmentioning

confidence: 99%

Molecular detection of Pneumocystis jirovecii using polymerase chain reaction in immunocompromised patients with pulmonary disorders in northeast of Iran

et al. 2015

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“…A few reports have studied diabetic patients with PCP, but neither clarified the association between PCP and diabetes at the time. [ 6 , 7 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 , 5 ] Only a few reports of PCP have focused on non-HIV-infected diabetic patients, and the association between diabetes and PCP is unknown. [ 6 , 7 ] In contrast to HIV-positive patients, PCP in HIV-negative patients has a more abrupt onset, more rapid progress, and a poor prognosis with a mortality rate of 30.6%. [ 2 , 8 ] We herein report a rare case of PCP in diabetes mellitus, aiming to enhance clinical awareness, improve outcomes, and avoid misdiagnosis or missed diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Pneumocystis pneumonia in a patient with diabetes mellitus: A case report

Shi

et al. 2023

Medicine

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Rationale: Pneumocystis pneumonia (PCP) is an opportunistic infection of patients with congenital or acquired immunodeficiency. It is most frequently occurred in human immunodeficiency virus (HIV) infection, organ transplantation, leukemia, and immunosuppressive therapy. Here we describe the rare case of PCP in a non-HIV-infected diabetic patient and find possible reasons for the association through a literature review. Patient concerns: A 65-years-old male was admitted to our hospital due to a 10-year history of abnormal blood glucose levels and edema of both lower extremities for half a month. However, the patient developed a high fever and progressive dyspnea during hospitalization. Diagnoses: The patient had elevated blood sugar levels, a low white blood cell count within normal limits, and severe lymphopenia. His blood G test and lactate dehydrogenase levels increased significantly. Multiple sputa and bronchoalveolar lavage fluid specimens for Pneumocystis jirovecii (PJ) nucleic acid detection were positive. Chest computed tomography scan demonstrated hazy patchy shadows in the lungs suspected to be pulmonary infections. No tumor, transplantation, or an autoimmune disease was found in the examinations. The patient was diagnosed with PCP finally. Interventions: A combination of oral trimethoprim-sulfamethoxazole and intravenous caspofungin was administered immediately against PJ. The patient was also treated with noninvasive ventilator-assisted ventilation, subcutaneous insulin, and hemodialysis therapy. Outcomes: The patient was discharged home finally with a fair general condition and was followed up without respiratory symptoms. Lessons: The compromised immunity in HIV-negative patients with diabetes may be related to lymphocyte decrease and dysfunction, which may cause diabetic patients prone to PJ. Although PCP is rare in diabetes, it should be paid attention to the high rate of misdiagnosis and missed diagnosis.

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“…Nevez ve arkadaşları diyabetik hastalarda P. jirovecii kolonizasyonundan bahsetmişlerdir (19). Sanno ve arkadaşları da PCP gelişen bir diyabet hastası tanımlamışlardır (20). Araştırmacılara göre diyabet hastalarında CD4+ sayısında belirgin bir azalma beklenmediği ancak kontrolsüz diyabetiklerin viral enfeksiyonlara son derece açık olmasından dolayı, gelişen enfeksiyonlar sonucu CD4 sayısında azalma olabileceği ve bu şekilde PCP gelişimi için bir risk oluşabileceği belirtilmiş-tir (20).…”

Section: Olgu Sunumuunclassified

Pneumocystis jirovecii Pneumonia in a Patient with Interstitial Lung

Özkoç¹,

Alpaydın²,

Delıbaş³

et al. 2015

TurkiyeParazitolDerg

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ÖZETPneumocystis jirovecii (P. jirovecii)'nin neden olduğu Pneumocystis pnömonisi (PCP) immun sistemin baskılandığı durumlarda ortaya çıkan fırsatçı bir akciğer enfeksiyonudur. Burada solunum sıkıntısı ile hastanemize başvuran ve bronkoalveolar lavaj (BAL) sıvısı örneklerinde P. jirovecii ve Aspergillus fumigatus saptanan 49 yaşında bayan hasta sunulmuştur. İnterstisyel akciğer hastalığı nedeniyle kortikosteroid kullanan ve aynı zamanda diyabet hastası olan bu olgu immunsupresyon zemininde gelişen koinfeksiyonu tanımlaması açısından önemlidir. (Turkiye Parazitol Derg 2015; 39: 66-9) Anahtar Sözcükler: Pneumocystis, pnömoni, interstisiyal akciğer hastalığı Geliş Tarihi: 13 Aralık 2013Kabul Tarihi: 4 Eylül 2014 ABSTRACTPneumocystis pneumonia (PCP) caused by Pneumocystis jirovecii (P. jirovecii) is an opportunistic pulmonary infection that occurs in immunocompromised patients. Here, a 49-year-old female patient who was admitted to our hospital with respiratuary distress and whose bronchoalveolar lavage (BAL) fluid specimens had P. jirovecii and Aspegillus fumigatus was presented. She had been treated with corticosteroids because of interstisial lung disease and she was also diabetic. It is important to define the coinfection developed in the presence of immunosuppression. (Turkiye Parazitol Derg 2015; 39: 66-9)

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Pneumocystis Pneumonia in a Patient with Type 2 Diabetes Mellitus

Abstract: A 76-year-old man, who

Cited by 4 publications

References 6 publications

Molecular detection of Pneumocystis jirovecii using polymerase chain reaction in immunocompromised patients with pulmonary disorders in northeast of Iran

Molecular detection of Pneumocystis jirovecii using polymerase chain reaction in immunocompromised patients with pulmonary disorders in northeast of Iran

Pneumocystis pneumonia in a patient with diabetes mellitus: A case report

Pneumocystis jirovecii Pneumonia in a Patient with Interstitial Lung

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