HIV-related Pneumocystis jirovecii pneumonia managed with caspofungin and veno-venous extracorporeal membrane oxygenation rescue therapy
Author(s)
Lee, Nathaniel
Lawrence, David
Patel, Brijesh
Ledot, Stephane
Type
Journal Article
Abstract
Patients with pneumocystis pneumonia have a risk of progressing to acute respiratory failure necessitating admission to intensive care. The case described is of a patient with a newly diagnosed HIV infection presenting with pneumocystis pneumonia. Despite initiating the appropriate pharmacological treatment the patient's clinical condition deteriorated, and required both rescue pharmacological therapy with echinocandins as well as respiratory support with extracorporeal membrane oxygenation therapy. The patient recovered well on ventilator and circulatory support despite a long weaning process complicated by sequelae common to pneumocystis pneumonia. Following initialisation of antiretroviral therapy and step-down from an intensive care setting, the patient required further prolonged hospital stay for rehabilitation and mental health support before being discharged. This case reviews the novel pharmacological therapies and respiratory support strategies used in cases of pneumocystis pneumonia, including the clinical and psychological sequelae that may follow.
Date Issued
2017-01
Date Acceptance
2017-08-16
Citation
BMJ Case Reports, 2017, 2017
ISSN
1757-790X
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Case Reports
Volume
2017
Copyright Statement
© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/28978595
Subjects
Antifungal Agents
Anti-Retroviral Agents
Cough
Diagnosis, Differential
Drug Therapy, Combination
Echinocandins
Extracorporeal Membrane Oxygenation
Female
Fever
HIV Infections
Humans
Middle Aged
Pneumocystis carinii
Pneumonia, Pneumocystis
Tomography, X-Ray Computed
adult intensive care
HIV/AIDS
mechanical ventilation
Publication Status
Published
Coverage Spatial
England
Article Number
bcr-2017-22121
Date Publish Online
2017-10-04