Infect Chemother.  2012 Dec;44(6):491-494. 10.3947/ic.2012.44.6.491.

A Case of Successfully Treated Pneumocystis jiroveci Pneumonia in CMV-associated IgA Nephropathy

• Lee MY
• Jang SH
• Park MJ
• Hwang WM
• Yun SR

• KMID: 1806940
• DOI: http://doi.org/10.3947/ic.2012.44.6.491

Abstract

A range of infections including cytomegalovirus (CMV) infections are associated with IgA nephropathy. Several reports have suggested that the risk of Pneumocystis infections is lower in the presence of preceding immunomodulating infections, such as a CMV infection. We report a patient with Pneumocystis jiroveci pneumonia (PJP) in CMV-associated IgA nephropathy, who was treated with trimethoprim/sulfamethoxazole and gancyclovir. A 52 year old man suffered from fever, chill and dyspnea for 2 days. He has taken low dose immunosuppressants (prednisolone, cyclophosphamide) for 3 months due to IgA nephropathy. PJP was confirmed by Chest CT and P.jiroveci PCR was performed from a bronchoalveolar lavage. His CMV serology was CMV-IgM/IgG(-/+) and CMV PCR (+), and his urine CMV culture was positive. The patient recovered completely from pneumonia after administering oral trimethoprim/sulfamethoxazole and intravenous ganciclovir, and his renal function and proteinuria improved.

Keyword

Glemerulonephritis; IGA; Pneumocystis; Cytomegalovirus

MeSH Terms

Bronchoalveolar Lavage
Cytomegalovirus
Dyspnea
Fever
Ganciclovir
Glomerulonephritis, IGA
Humans
Immunoglobulin A
Immunosuppressive Agents
Pneumocystis
Pneumocystis Infections
Pneumocystis jirovecii
Pneumonia
Polymerase Chain Reaction
Proteinuria
Thorax
Ganciclovir
Immunoglobulin A
Immunosuppressive Agents

Figure

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  Figure 1 Chest CT shows ground glass haziness and multifocal consolidation in both lungs.

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