Concurrent COVID-19 and Pneumocystis jirovecii pneumonia : The importance of radiological diagnostic and HIV testing

© 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington..

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has changed the focus of healthcare and become a public health challenge around the world. The coinfection of SARS-CoV-2 with other microorganisms, including fungi, can cause difficult diagnosis and a worse prognosis. Pneumocystis jirovecii pneumonia (PJP) is a common opportunistic infection in human immunodeficiency virus (HIV) patients. However, sometimes the diagnosis is late presented after PJP finding on chest X-ray. We report a 24-year-old man with COVID-19 and PJP. Reverse transcriptase-polymerase chain reaction showed positive for SARS-CoV-2. HIV diagnosis was late presented after PJP finding on chest X-ray examination. HIV serology was positive with an absolute CD4+ count was 16 cells/mm3. He was treated with remdesivir IV, methylprednisolone IV, heparin, and cefoperazone-sulbactam IV. He was discharged after being admitted for 25 days. HIV treatment was started in outpatient services. Radiological diagnostic to diagnose concurrent COVID-19 and PJP pneumonia are important, especially in the setting where microscopic examination of sputum or Bronchoalveolar Lavage Fluid (BALF) is not available, or because BAL and sputum induction are aerosol-generating procedures that potentially increase the risk of COVID-19 transmission. HIV testing in COVID-19 patients was also should be considered as part of directed screening in patients presenting with features of PJP, especially for those with unknown HIV status. The determination of an appropriate corticosteroid dose is important to treat both COVID-19 and PJP with severe clinical features. Proper diagnosis and treatment co-infections are urgently needed in this current pandemic to reduce morbidity and mortality.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

Radiology case reports - Vol. 16, No. 12 (2021), p. 3685-3689

Language:

English

Contributors:

Anggraeni, Amelia Tantri
Soedarsono, Soedarsono
Soeprijanto, Bambang

Links:

Volltext

Keywords:

COVID-19
Case Reports
HIV
PJP
Radiological Diagnosis
SARS-CoV-2

Notes:

Date Revised 12.10.2021

published: Electronic-eCollection

Citation Status PubMed-not-MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1016/j.radcr.2021.09.002

PMID:

34630801

PPN (Catalogue-ID):

NLM332855856