Pneumocystis jiroveci pneumonia in Taiwan from 2014 to 2017: Clinical manifestations and outcomes between pediatric and adult patients
Background: Pneumocystis jiroveci pneumonia (PJP) is a severe and lethal opportunistic infection in the immunocompromised patients. As the increasing usage of immunosuppressants, the incidence of non-HIV related PJP has increased in recent years. Still, there is little research regarding children wi...
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doaj-2034f91163e3438db76ff616cd57749d2020-11-25T01:51:37ZengElsevierJournal of Microbiology, Immunology and Infection1684-11822019-12-01526983990Pneumocystis jiroveci pneumonia in Taiwan from 2014 to 2017: Clinical manifestations and outcomes between pediatric and adult patientsHsin-Yao Lee0Chun-Yi Lu1Ping-Ing Lee2Jong-Min Chen3Li-Min Huang4Luan-Yin Chang5Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanCorresponding author. Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, 8 Chung-Shan South Road, Taipei 10002, Taiwan. Fax: +886 2 2314 7450.; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, TaiwanBackground: Pneumocystis jiroveci pneumonia (PJP) is a severe and lethal opportunistic infection in the immunocompromised patients. As the increasing usage of immunosuppressants, the incidence of non-HIV related PJP has increased in recent years. Still, there is little research regarding children with PJP. The aim of this study is to understand PJP more among pediatric population. Methods: We reviewed the medical records of the patients with PJP in National Taiwan University Hospital from 2014 to 2017. Diagnosis was made if the patient met all of the criteria: presence of relevant pulmonary symptoms and signs, pulmonary infiltrates on images, detection of Pneumocystis jiroveci from respiratory specimens via polymerase chain reaction (PCR), and received antibiotics for PJP. Results: Twenty children and 132 adults were enrolled in this study. The most common underlying diseases among children included malignancy (40%), post-transplantation (30%), and primary immunodeficiency (20%). The major underlying diseases in adults included malignancy (36%), HIV with acquired immunodeficiency syndrome (AIDS) (31%), and autoimmune diseases (24%). There is no significant difference in the clinical manifestations, mortality, and complication between children and adults, but children tended to have less chance of using alternative antibiotics, methylprednisolone and inhaled nitric oxide (NO). The chance of concomitant cytomegalovirus disease was also significantly lower in pediatric patients. Conclusion: No significant difference was found in the clinical manifestations, mortality, and complication between children and adults, but children tended to have lesser chance of using alternative antibiotics, methylprednisolone and inhaled NO. The chance of associated cytomegalovirus (CMV) disease was also significantly lower in children. Keywords: Opportunistic infection, Pediatric, Pneumocystis jiroveci pneumoniahttp://www.sciencedirect.com/science/article/pii/S1684118219300519 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hsin-Yao Lee Chun-Yi Lu Ping-Ing Lee Jong-Min Chen Li-Min Huang Luan-Yin Chang |
spellingShingle |
Hsin-Yao Lee Chun-Yi Lu Ping-Ing Lee Jong-Min Chen Li-Min Huang Luan-Yin Chang Pneumocystis jiroveci pneumonia in Taiwan from 2014 to 2017: Clinical manifestations and outcomes between pediatric and adult patients Journal of Microbiology, Immunology and Infection |
author_facet |
Hsin-Yao Lee Chun-Yi Lu Ping-Ing Lee Jong-Min Chen Li-Min Huang Luan-Yin Chang |
author_sort |
Hsin-Yao Lee |
title |
Pneumocystis jiroveci pneumonia in Taiwan from 2014 to 2017: Clinical manifestations and outcomes between pediatric and adult patients |
title_short |
Pneumocystis jiroveci pneumonia in Taiwan from 2014 to 2017: Clinical manifestations and outcomes between pediatric and adult patients |
title_full |
Pneumocystis jiroveci pneumonia in Taiwan from 2014 to 2017: Clinical manifestations and outcomes between pediatric and adult patients |
title_fullStr |
Pneumocystis jiroveci pneumonia in Taiwan from 2014 to 2017: Clinical manifestations and outcomes between pediatric and adult patients |
title_full_unstemmed |
Pneumocystis jiroveci pneumonia in Taiwan from 2014 to 2017: Clinical manifestations and outcomes between pediatric and adult patients |
title_sort |
pneumocystis jiroveci pneumonia in taiwan from 2014 to 2017: clinical manifestations and outcomes between pediatric and adult patients |
publisher |
Elsevier |
series |
Journal of Microbiology, Immunology and Infection |
issn |
1684-1182 |
publishDate |
2019-12-01 |
description |
Background: Pneumocystis jiroveci pneumonia (PJP) is a severe and lethal opportunistic infection in the immunocompromised patients. As the increasing usage of immunosuppressants, the incidence of non-HIV related PJP has increased in recent years. Still, there is little research regarding children with PJP. The aim of this study is to understand PJP more among pediatric population. Methods: We reviewed the medical records of the patients with PJP in National Taiwan University Hospital from 2014 to 2017. Diagnosis was made if the patient met all of the criteria: presence of relevant pulmonary symptoms and signs, pulmonary infiltrates on images, detection of Pneumocystis jiroveci from respiratory specimens via polymerase chain reaction (PCR), and received antibiotics for PJP. Results: Twenty children and 132 adults were enrolled in this study. The most common underlying diseases among children included malignancy (40%), post-transplantation (30%), and primary immunodeficiency (20%). The major underlying diseases in adults included malignancy (36%), HIV with acquired immunodeficiency syndrome (AIDS) (31%), and autoimmune diseases (24%). There is no significant difference in the clinical manifestations, mortality, and complication between children and adults, but children tended to have less chance of using alternative antibiotics, methylprednisolone and inhaled nitric oxide (NO). The chance of concomitant cytomegalovirus disease was also significantly lower in pediatric patients. Conclusion: No significant difference was found in the clinical manifestations, mortality, and complication between children and adults, but children tended to have lesser chance of using alternative antibiotics, methylprednisolone and inhaled NO. The chance of associated cytomegalovirus (CMV) disease was also significantly lower in children. Keywords: Opportunistic infection, Pediatric, Pneumocystis jiroveci pneumonia |
url |
http://www.sciencedirect.com/science/article/pii/S1684118219300519 |
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