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VOLUME 2 , ISSUE 2 ( March-April, 2023 ) > List of Articles


Pneumocystis Pneumonia: The Challenges Continue

Aashna Gandhi, Nikhil Shirsi, Anjali Khalane, Guruprasad P Bhosale, Geethu Joe, Rajeev Soman

Keywords : Carcinoma of pancreas, Gemcitabine, Pneumocystis pneumonia

Citation Information : Gandhi A, Shirsi N, Khalane A, Bhosale GP, Joe G, Soman R. Pneumocystis Pneumonia: The Challenges Continue. 2023; 2 (2):31-33.

DOI: 10.5005/jp-journals-11006-0042

License: CC BY-NC 4.0

Published Online: 06-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


A 56-year-old female patient with carcinoma of the pancreas on chemotherapy with gemcitabine, presented with a short history of fever, cough, and breathlessness. She was found to be hypoxic on admission and there were diffuse ground glass opacities with peripheral and basal sparing on high-resolution computed tomography (HRCT). Serum lactate dehydrogenase (LDH) and serum β-D-glucan (BDG) were high, and gomori methamine silver (GMS) staining from the throat gargle specimen showed typical cysts of Pneumocystis pneumonia (PCP). Therefore, she received treatment with trimethoprim/sulfamethoxazole (TMP/SMX) and steroids at first, which was later changed to primaquine + clindamycin in view of TMP/SMX-related toxicity. However, despite all measures, she succumbed to the illness. This case highlights the importance of PCP in immunocompromised hosts other than human immunodeficiency virus (HIV), the role of serum markers like LDH and BDG,6 and the use of throat gargle samples5 for microscopy and polymerase chain reaction (PCR). An unmet clinical need is a guide to prophylaxis, therapy, and adjuvant steroids in non-HIV patients.9

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