Severe hypoxemic respiratory failure caused by Pneumocystis jirovecii in a late kidney transplant recipient

John Fredy Nieto-Ríos, Mónica Zuluaga-Quintero, Arbey Aristizábal-Alzate, Catalina Ocampo-Kohn, Lina María Serna-Higuita, Isabel Cristina Ramírez-Sánchez, Gustavo Adolfo Zuluaga-Valencia, .

Keywords: Pneumocystis jirovecii, kidney transplantation, respiratory insufficiency, mortality, graft rejection

Abstract

Pneumonia caused by Pneumocystis jirovecii is an uncommon infection in kidney transplant patients that can have an acute and rapid progression to respiratory failure and death. The period of greatest risk occurs in the first six months after the transplant, and it relates to the high doses of immunosuppression drugs required by patients. However, it may occur late, associated with the suspension of prophylaxis with trimethoprim-sulfamethoxazole.
We present two cases of renal transplant patients who had severe hypoxemic respiratory failure due to P. jirovecii six years after transplantation. In addition to steroids, they received treatment with trimethoprim-sulfamethoxazole. One patient died, while the other had clinical recovery, with preservation of the renal graft function.

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  • John Fredy Nieto-Ríos Departamento de Nefrología, Hospital Pablo Tobón Uribe, Medellín, Colombia Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
  • Mónica Zuluaga-Quintero Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
  • Arbey Aristizábal-Alzate Departamento de Nefrología, Hospital Pablo Tobón Uribe, Medellín, Colombia
  • Catalina Ocampo-Kohn Departamento de Nefrología, Hospital Pablo Tobón Uribe, Medellín, Colombia Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
  • Lina María Serna-Higuita Departamento de Bioestadística, Hospital Universitario, Tubinga, Alemania
  • Isabel Cristina Ramírez-Sánchez Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia Departamento de Infectología, Hospital Pablo Tobón Uribe, Medellín, Colombia
  • Gustavo Adolfo Zuluaga-Valencia Departamento de Nefrología, Hospital Pablo Tobón Uribe, Medellín, Colombia

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How to Cite
1.
Nieto-Ríos JF, Zuluaga-Quintero M, Aristizábal-Alzate A, Ocampo-Kohn C, Serna-Higuita LM, Ramírez-Sánchez IC, et al. Severe hypoxemic respiratory failure caused by Pneumocystis jirovecii in a late kidney transplant recipient. biomedica [Internet]. 2018 Mar. 15 [cited 2024 May 18];38(1):32-6. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/3589

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Published
2018-03-15
Section
Case presentation

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