Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis : a case series
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: Pneumocystis jirovecii pneumonia (PCP) incidence is increasing in people without HIV. Decompensated liver cirrhosis is not currently considered a risk factor for PCP. The aim of this paper is to describe a case series of patients with decompensated liver cirrhosis and PCP.
METHODS: All consecutive patients hospitalized with decompensated cirrhosis and microbiology-confirmed PCP at Policlinico Modena University Hospital from January 1, 2016 to December 31, 2021 were included in our series.
RESULTS: Eight patients were included. All patients had advanced-stage liver disease with a model for end-stage liver disease score above 15 (6/8 above 20). Four were on an active orthotopic liver transplant waiting list at the time of PCP diagnosis. Five patients did not have any traditional risk factor for PCP, whereas the other three were on glucocorticoid treatment for acute-on-chronic liver failure. All patients were treated with cotrimoxazole, except two who died before the diagnosis. Five patients died (62.5%), four of them within 30 days from PCP diagnosis. Of the remaining three, one patient underwent liver transplantation.
CONCLUSION: Although further studies are needed, liver cirrhosis can be an independent risk factor for PCP in patients with decompensated cirrhosis that is mainly due to severe alcoholic hepatitis and who are on corticosteroids therapy, and primary prophylaxis for PCP should be considered.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:128 |
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| Enthalten in: |
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases - 128(2023) vom: 15. März, Seite 254-256 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Franceschini, Erica [VerfasserIn] |
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| Links: |
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| Themen: |
Case Reports |
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| Anmerkungen: |
Date Completed 27.02.2023 Date Revised 27.02.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijid.2022.12.027 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM351217517 |
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| 245 | 1 | 0 | |a Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis |b a case series |
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| 500 | |a Date Revised 27.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: Pneumocystis jirovecii pneumonia (PCP) incidence is increasing in people without HIV. Decompensated liver cirrhosis is not currently considered a risk factor for PCP. The aim of this paper is to describe a case series of patients with decompensated liver cirrhosis and PCP | ||
| 520 | |a METHODS: All consecutive patients hospitalized with decompensated cirrhosis and microbiology-confirmed PCP at Policlinico Modena University Hospital from January 1, 2016 to December 31, 2021 were included in our series | ||
| 520 | |a RESULTS: Eight patients were included. All patients had advanced-stage liver disease with a model for end-stage liver disease score above 15 (6/8 above 20). Four were on an active orthotopic liver transplant waiting list at the time of PCP diagnosis. Five patients did not have any traditional risk factor for PCP, whereas the other three were on glucocorticoid treatment for acute-on-chronic liver failure. All patients were treated with cotrimoxazole, except two who died before the diagnosis. Five patients died (62.5%), four of them within 30 days from PCP diagnosis. Of the remaining three, one patient underwent liver transplantation | ||
| 520 | |a CONCLUSION: Although further studies are needed, liver cirrhosis can be an independent risk factor for PCP in patients with decompensated cirrhosis that is mainly due to severe alcoholic hepatitis and who are on corticosteroids therapy, and primary prophylaxis for PCP should be considered | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Liver cirrhosis | |
| 650 | 4 | |a Liver failure | |
| 650 | 4 | |a Pneumocystis pneumonia | |
| 650 | 4 | |a Primary prophylaxis | |
| 700 | 1 | |a Dolci, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Santoro, Antonella |e verfasserin |4 aut | |
| 700 | 1 | |a Meschiari, Marianna |e verfasserin |4 aut | |
| 700 | 1 | |a Riccò, Alice |e verfasserin |4 aut | |
| 700 | 1 | |a Menozzi, Marianna |e verfasserin |4 aut | |
| 700 | 1 | |a Burastero, Giulia Jole |e verfasserin |4 aut | |
| 700 | 1 | |a Cuffari, Biagio |e verfasserin |4 aut | |
| 700 | 1 | |a De Maria, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Serio, Lucia |e verfasserin |4 aut | |
| 700 | 1 | |a Biagioni, Emanuela |e verfasserin |4 aut | |
| 700 | 1 | |a Catellani, Barbara |e verfasserin |4 aut | |
| 700 | 1 | |a Sandro, Stefano Di |e verfasserin |4 aut | |
| 700 | 1 | |a Colecchia, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Girardis, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Benedetto, Fabrizio Di |e verfasserin |4 aut | |
| 700 | 1 | |a Mussini, Cristina |e verfasserin |4 aut | |
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