Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case series
Objectives: Pneumocystis jirovecii pneumonia (PCP) incidence is increasing in people without HIV. Decompensated liver cirrhosis is not currently considered a risk factor for PCP. The aim of this paper is to describe a case series of patients with decompensated liver cirrhosis and PCP. Methods: All c...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S120197122200666X |
| _version_ | 1797897312433864704 |
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| author | Erica Franceschini Giovanni Dolci Antonella Santoro Marianna Meschiari Alice Riccò Marianna Menozzi Giulia Jole Burastero Biagio Cuffari Nicola De Maria Lucia Serio Emanuela Biagioni Barbara Catellani Stefano Di Sandro Antonio Colecchia Massimo Girardis Fabrizio Di Benedetto Cristina Mussini |
| author_facet | Erica Franceschini Giovanni Dolci Antonella Santoro Marianna Meschiari Alice Riccò Marianna Menozzi Giulia Jole Burastero Biagio Cuffari Nicola De Maria Lucia Serio Emanuela Biagioni Barbara Catellani Stefano Di Sandro Antonio Colecchia Massimo Girardis Fabrizio Di Benedetto Cristina Mussini |
| author_sort | Erica Franceschini |
| collection | DOAJ |
| description | Objectives: Pneumocystis jirovecii pneumonia (PCP) incidence is increasing in people without HIV. Decompensated liver cirrhosis is not currently considered a risk factor for PCP. The aim of this paper is to describe a case series of patients with decompensated liver cirrhosis and PCP. Methods: All consecutive patients hospitalized with decompensated cirrhosis and microbiology-confirmed PCP at Policlinico Modena University Hospital from January 1, 2016 to December 31, 2021 were included in our series. Results: Eight patients were included. All patients had advanced-stage liver disease with a model for end-stage liver disease score above 15 (6/8 above 20). Four were on an active orthotopic liver transplant waiting list at the time of PCP diagnosis. Five patients did not have any traditional risk factor for PCP, whereas the other three were on glucocorticoid treatment for acute-on-chronic liver failure. All patients were treated with cotrimoxazole, except two who died before the diagnosis. Five patients died (62.5%), four of them within 30 days from PCP diagnosis. Of the remaining three, one patient underwent liver transplantation. Conclusion: Although further studies are needed, liver cirrhosis can be an independent risk factor for PCP in patients with decompensated cirrhosis that is mainly due to severe alcoholic hepatitis and who are on corticosteroids therapy, and primary prophylaxis for PCP should be considered. |
| first_indexed | 2024-04-10T07:56:34Z |
| format | Article |
| id | doaj.art-932d5a79b0004e8db2a0f9cc0f94cd6d |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-04-10T07:56:34Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-932d5a79b0004e8db2a0f9cc0f94cd6d2023-02-23T04:30:22ZengElsevierInternational Journal of Infectious Diseases1201-97122023-03-01128254256Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case seriesErica Franceschini0Giovanni Dolci1Antonella Santoro2Marianna Meschiari3Alice Riccò4Marianna Menozzi5Giulia Jole Burastero6Biagio Cuffari7Nicola De Maria8Lucia Serio9Emanuela Biagioni10Barbara Catellani11Stefano Di Sandro12Antonio Colecchia13Massimo Girardis14Fabrizio Di Benedetto15Cristina Mussini16Infectious Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy; Corresponding author: Dr. Erica Franceschini, Infectious Disease Unit, Azienda Ospedaliero-Universitaria of Modena, Largo del Pozzo 71, 41124, Modena, Italy, Tel: +39 0594225317, Fax: +39 0594223709Infectious Diseases Unit, University of Modena and Reggio Emilia, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, ItalyInfectious Diseases Unit, University of Modena and Reggio Emilia, Modena, ItalyGastroenterology Unit, Azienda Ospedaliero-Universitaria Policlinico, Modena, ItalyGastroenterology Unit, Azienda Ospedaliero-Universitaria Policlinico, Modena, ItalyIntensive Care Unit, Department of Anaesthesia, Azienda Ospedaliero-Universitaria Policlinico, Modena, ItalyIntensive Care Unit, Department of Anaesthesia, Azienda Ospedaliero-Universitaria Policlinico, Modena, ItalyHepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, ItalyHepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, ItalyGastroenterology Unit, Azienda Ospedaliero-Universitaria Policlinico, Modena, ItalyIntensive Care Unit, Department of Anaesthesia, Azienda Ospedaliero-Universitaria Policlinico, Modena, ItalyHepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy; Infectious Diseases Unit, University of Modena and Reggio Emilia, Modena, ItalyObjectives: Pneumocystis jirovecii pneumonia (PCP) incidence is increasing in people without HIV. Decompensated liver cirrhosis is not currently considered a risk factor for PCP. The aim of this paper is to describe a case series of patients with decompensated liver cirrhosis and PCP. Methods: All consecutive patients hospitalized with decompensated cirrhosis and microbiology-confirmed PCP at Policlinico Modena University Hospital from January 1, 2016 to December 31, 2021 were included in our series. Results: Eight patients were included. All patients had advanced-stage liver disease with a model for end-stage liver disease score above 15 (6/8 above 20). Four were on an active orthotopic liver transplant waiting list at the time of PCP diagnosis. Five patients did not have any traditional risk factor for PCP, whereas the other three were on glucocorticoid treatment for acute-on-chronic liver failure. All patients were treated with cotrimoxazole, except two who died before the diagnosis. Five patients died (62.5%), four of them within 30 days from PCP diagnosis. Of the remaining three, one patient underwent liver transplantation. Conclusion: Although further studies are needed, liver cirrhosis can be an independent risk factor for PCP in patients with decompensated cirrhosis that is mainly due to severe alcoholic hepatitis and who are on corticosteroids therapy, and primary prophylaxis for PCP should be considered.http://www.sciencedirect.com/science/article/pii/S120197122200666XPneumocystis pneumoniaLiver cirrhosisLiver failurePrimary prophylaxis |
| spellingShingle | Erica Franceschini Giovanni Dolci Antonella Santoro Marianna Meschiari Alice Riccò Marianna Menozzi Giulia Jole Burastero Biagio Cuffari Nicola De Maria Lucia Serio Emanuela Biagioni Barbara Catellani Stefano Di Sandro Antonio Colecchia Massimo Girardis Fabrizio Di Benedetto Cristina Mussini Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case series International Journal of Infectious Diseases Pneumocystis pneumonia Liver cirrhosis Liver failure Primary prophylaxis |
| title | Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case series |
| title_full | Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case series |
| title_fullStr | Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case series |
| title_full_unstemmed | Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case series |
| title_short | Pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis: a case series |
| title_sort | pneumocystis jirovecii pneumonia in patients with decompensated cirrhosis a case series |
| topic | Pneumocystis pneumonia Liver cirrhosis Liver failure Primary prophylaxis |
| url | http://www.sciencedirect.com/science/article/pii/S120197122200666X |
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