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

Mi Young Lee; Suk Hyun Jang; Min Ji Park; Won Min Hwang; Sung Ro Yun

doi:10.3947/ic.2012.44.6.491

Journal List > Infect Chemother > v.44(6) > 1035207

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Lee, Jang, Park, Hwang, and Yun: A Case of Successfully Treated Pneumocystis jiroveci Pneumonia in CMV-associated IgA Nephropathy

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(6): 491-494.

Published online: 31 December 2012

DOI: https://doi.org/10.3947/ic.2012.44.6.491

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

Mi Young Lee, Suk Hyun Jang, Min Ji Park, Won Min Hwang, Sung Ro Yun

Department of Internal Medicine, College of Medicine, Konyang University, Daejeon, Korea.

Correspondence to Won-Min Hwang, MD. Department of Internal medicine, Konyang University Hospital, College of Medicine, Konyang University, 685, Gasoowon-dong, Seo-gu, Daejeon 302-718, Korea. Tel: +82-42-600-9066, Fax: +82-42-600-9092, hwangwm@kyuh.ac.kr

Received 6 May 2012 Revised 5 June 2012 Accepted 22 June 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Glemerulonephritis, IGA, Pneumocystis, Cytomegalovirus

Figures and Tables

Figure 1

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

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