A Case of Pneumocystis jirovecii Pneumonia Following CMV Duodenitis in a Kidney Transplant Patient

Korean Journal of Nephrology 2008;27(5):631-637.

Hye-Won Kim, M.D., Myung-Gyu Kim, M.D., Young-Seok Woo, M.D., Cang-Soo Boo, M.D., Sang-Kyung Jo, M.D., Hyoung-Kyu Kim, M.D., Won-Yong Jo, M.D., Kwang-Gyun Lee, M.D., Hye-Ok Kim, M.D., Cho-rong Oh, M.D. and Ju Hyung Kim, M.D.

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

증례 : 신장 이식 환자에서 CMV duodenitis 치료 후 병발한 Pneumocystis jirovecii 폐렴 1예

김혜원, 김명규, 우영석, 부창수, 조상경, 김형규, 조원용, 이광균, 김혜옥, 오초롱, 김주형

고려대학교 의과대학 내과학교실

Abstract

Solid organ transplant recipients are at increased risk for various opportunistic infections because of their immunocompromised state. Pneumocystis jirovecii (carinii) infection has posed serious problems in these patients which can be life threatening. It has been reported that incidences of Pneumocystis infection have dramatically decreased with the use of prophylactic antibiotics. However, there have been reports that say the risks of Pneumocystis infection are increasing with the use of new immunosuppressive drugs and in presence of preceding immunomodulating infections such as CMV infection which is another common opportunistic infection in transplant patients. There were only a few case reports abroad on Pneumocystis infection following CMV infection in patients who underwent kidney transplantation. In Korea, however, there hasnt been any report of such cases. Herein we report a case of a kidney transplant patient who experienced a serious episode of Pneumocystis jirovecii pneumonia following CMV duodenitis. After adequate mechanical ventilation and use of antibiotics the patient completely recovered without any complications.

Key Words: Kidney transplantation, Pneumocystis, Cytomegalovirus