Successful Treatment of Severe Pneumocystis Pneumonia with Clindamycin-Primaquine in an HIV-Negative Patient

Crisp, Howard C.; Stewart, Ian J.; Blatz, Peter J.; Rice, D.; Okulicz, Jason F.

doi:10.1097/smj.0b013e3181bab1ed

Cited by 1 publication

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“…In AIDS patients with mild-to-moderate disease, the alternative agents used include atovaquone, clindamycin plus primaquine, and trimethoprim plus dapsone. 65,66 These agents can presumably be used for HIV-negative patients with PCP who absolutely cannot tolerate cotrimoxazole or who have contraindications. Intravenous pentamidine has been shown to be as effective as cotrimoxazole for PCP but is associated with more adverse effects including thrombocytopenia, hypoglycemia, hypotension, and renal failure (among others).…”

Section: Discussionmentioning

confidence: 99%

Pneumocystis Pneumonia in HIV-Negative Patients

Gripaldo

Lippmann

2012

Clinical Pulmonary Medicine

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In an effort to determine the characteristics and clinical outcomes of Pneumocystis pneumonia (PCP) in HIV-negative patients, we conducted a review of the English language medical literature focusing on the available clinical experiences in this group of patients. We also conducted a review of our own experience in our inner city, tertiary care facility of all adult HIV-negative patients who had histologic evidence of PCP. In our population, 111 patients were identified as having histologic evidence of PCP and 13 patients were found to be HIV negative (11.7%). Most of the patients had conditions associated with defective T-cell immunity, including the use of immunosuppressive medications. None of the patients were on PCP prophylaxis. Among the 13 patients, 11 patients were admitted to the intensive care unit with 8 of them requiring intubation and mechanical ventilation. Five of the patients died (38%). These findings are comparable with that of similar retrospective studies found in the medical literature. Given the high mortality in this group of patients, we conclude that a high index of suspicion for PCP should be present when evaluating HIV-negative patients with predisposing conditions associated with defective T-cell immunity when they present with respiratory insufficiency. PCP prophylaxis should also be strongly considered in this group of patients.

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Section: Discussionmentioning

confidence: 99%