Pneumocystis pneumonia in the COVID-19 pandemic era: similarities and challenges

Szydłowicz, Magdalena; Matos, Olga

doi:10.1016/j.pt.2021.07.010

Cited by 23 publications

(23 citation statements)

References 15 publications

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“…Second, the patient could have PCP from the start, misdiagnosed as COVID-19. The clinical manifestations of pneumonia caused by SARS-CoV-2 and P.jirovecii are similar ( 6 ). Both of them show bilateral ground-glass opacities in lung CT scan.…”

Section: Discussionmentioning

confidence: 99%

“…Table 1 presents the laboratory findings of the patient. The spiral chest Computed tomography (CT) scan showed bilateral ground-glass opacities (compatible with COVID-19 pneumonia) and multiple nodules (consistent with CMV pneumonia or fungal infections) ( 6 , 7 ). Thus, to cover all the differential diagnoses mentioned above, we prescribed the following drugs:…”

Section: Case Descriptionmentioning

confidence: 99%

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Case Report: Pneumonia in a Patient With Combined Variable Immunodeficiency: COVID-19 or Pneumocystis Pneumonia?

et al. 2022

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Combined variable immunodeficiency (CVID) is a primary immunodeficiency, characterized by impairment in immune system function. These patients are susceptible to opportunistic infections, which may mimic COVID-19 manifestations. Also, misdiagnosis or delayed diagnosis of opportunistic infections can lead to perilous consequences. We report a 28-year-old woman with a history of combined variable immunodeficiency disorder (CVID) and ulcerative colitis (UC) complained of fever, cough, and dyspnea. According to the clinical and radiological manifestations and the COVID-19 epidemic, she was admitted with a primary diagnosis of COVID-19 pneumonia. After a week, the patient did not respond to treatment, so she underwent bronchoscopy. Using polymerase chain reaction (PCR) methodology, we detected DNA of Pneumocystis jirovecii, the causative agent of a life-threatening pneumonia (PCP), in respiratory specimens. The patient was hypersensitive to common PCP treatments, so she was treated with high-dose clindamycin. However, the patient's clinical condition aggravated. Besides, we found evidence of pneumothorax, pneumomediastinum, and pneumopericardium in chest CT scan. We inserted a catheter for the patient to evacuate the air inside the mediastinum. Also, we added caspofungin to the treatment. The patient eventually recovered and was discharged from the hospital about a week later. Thus, during the COVID-19 epidemic, in febrile patients with respiratory symptoms, physicians should not think only of COVID-19. They must consider opportunistic infections such as PCP, especially in immunocompromised patients.

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Section: Discussionmentioning

confidence: 99%

Section: Case Descriptionmentioning

confidence: 99%

Case Report: Pneumonia in a Patient With Combined Variable Immunodeficiency: COVID-19 or Pneumocystis Pneumonia?

et al. 2022

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“…40 However, interpreting diffuse interstitial involvement could be challenging due low specificity of ground-glass opacities in this population. 41 42 43…”

Section: Discussionmentioning

confidence: 99%

“…40 However, interpreting diffuse interstitial involvement could be challenging due low specificity of ground-glass opacities in this population. [41][42][43] Disease severity and mortality data are retrospective with hospitalization rates varying from 29 to 86% and mortality rates varying from 4 to 36%. Indeed, immunocompromised patients seem to have more severe disease with higher rates of hospital and ICU admission and mortality.…”

Section: Vaccinationsmentioning

confidence: 99%

COVID-19 in Immunocompromised Patients: A Systematic Review

Stainer

Amati

Suigo

et al. 2021

Semin Respir Crit Care Med

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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first identified as a novel coronavirus in Wuhan, Hubei province, central China, in December 2019, and is responsible for the 2019-to-present pandemic. According to the most recent data released by the World Health Organization, more than 200 million people have been infected by SARS-CoV-2 so far, and more than 4 million people died worldwide. Although our knowledge on SARS-CoV-2 and COVID-19 is constantly growing, data on COVID-19 in immunocompromised patients are still limited. The aim of the present systematic review is to describe clinical picture, disease severity, proposed treatment regimen, and response to vaccination in patients with different types and severity of immunosuppression.

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“…Nonetheless, a negative qPCR result can rule out PCP. A high fungal load is helpful to establish probable disease, but a lower fungal load detected by qPCR requires additional diagnostic indicators [71,85]. A positive serum BDG (≥80 pg/mL) result can contribute to the diagnosis, particularly when combined with a positive PCR result, and negative BDG results can exclude infection in at-risk patients [71,86].…”

Section: Pneumocystis Pneumoniamentioning

confidence: 99%

Fungal Infections Other Than Invasive Aspergillosis in COVID-19 Patients

Basile¹,

Halliday

Kok

et al. 2022

JoF

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Invasive fungal disease (IFD) associated with Coronavirus Disease 2019 (COVID-19) has focussed predominantly on invasive pulmonary aspergillosis. However, increasingly emergent are non-Aspergillus fungal infections including candidiasis, mucormycosis, pneumocystosis, cryptococcosis, and endemic mycoses. These infections are associated with poor outcomes, and their management is challenged by delayed diagnosis due to similarities of presentation to aspergillosis or to non-specific features in already critically ill patients. There has been a variability in the incidence of different IFDs often related to heterogeneity in patient populations, diagnostic protocols, and definitions used to classify IFD. Here, we summarise and address knowledge gaps related to the epidemiology, risks, diagnosis, and management of COVID-19-associated fungal infections other than aspergillosis.

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Pneumocystis pneumonia in the COVID-19 pandemic era: similarities and challenges

Cited by 23 publications

References 15 publications

Case Report: Pneumonia in a Patient With Combined Variable Immunodeficiency: COVID-19 or Pneumocystis Pneumonia?

Case Report: Pneumonia in a Patient With Combined Variable Immunodeficiency: COVID-19 or Pneumocystis Pneumonia?

COVID-19 in Immunocompromised Patients: A Systematic Review

Fungal Infections Other Than Invasive Aspergillosis in COVID-19 Patients

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