ArticleCritical care (London, England)2018
Clinical course, treatment and outcome of Pneumocystis pneumonia in immunocompromised adults: a retrospective analysis over 17 years.
Article in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 1 of them a synthesis that pooled it.
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Who cites it
78 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Features and global impact of invasive fungal infections caused by Pneumocystis jirovecii: A systematic review to inform the World Health Organization fungal priority pathogens list.Medical mycology · 2024Pooled it
- Computed tomography-based radiomics improves non-invasive diagnosis of Pneumocystis jirovecii pneumonia in non-HIV patients: a retrospective study.BMC pulmonary medicine · 2024Trial
- Outcomes of concomitantAnnals of medicine · 2026Article
- A Review of the Therapeutic Challenges and Novel Treatment Options in Mitigating Invasive Mycosis Associated withJournal of fungi (Basel, Switzerland) · 2026Review
- Association between serum lactate dehydrogenase level and renal outcome in patients with advanced chronic kidney disease without diabetes mellitus.Clinical and experimental nephrology · 2026Article
- Extracorporeal Membrane Oxygenation for Pneumocystis Pneumonia: Outcomes in Patients From the Extracorporeal Life Support Organization.Critical care explorations · 2026Article
- Biphasic dysglycemia induced by pentamidine and detected by intermittently scanned continuous glucose monitoring: a case report of a possible drug-drug interaction with clopidogrel and literature review.Journal of pharmaceutical health care and sciences · 2026Article
- Clinical outcomes after switching from sulfamethoxazole-trimethoprim to atovaquone due to intolerance in patients with non-HIV Pneumocystis pneumonia: a single-center retrospective study.Journal of pharmaceutical health care and sciences · 2026Article
- Clinical course, treatment and outcome of severe pneumocystis pneumonia in patients with autoimmune or inflammatory diseases: a prospective study.Frontiers in cellular and infection microbiology · 2026Article
- Prognostic Significance of BALF Neutrophil Percentage and Hypoxemia in Non-HIVInfection and drug resistance · 2026Article
- Analysis of risk factors associated with in-hospital mortality in severe HIV-negative PCP patients: a retrospective cohort study.BMC infectious diseases · 2025Article
- Advances in pathogen detection ofInfectious medicine · 2025Review
- Mortality ofAnnals of medicine · 2025Article
- Clinical characteristics ofJournal of thoracic disease · 2025Article
- The 2025 EQUALJAC-antimicrobial resistance · 2025Article
- Significant Mortality Reduction from SeverePathogens (Basel, Switzerland) · 2025Article
- Article
- An Observational Analysis of a Large Cohort ofOpen forum infectious diseases · 2025Article
- A nomogram-based clinical prediction model for adverse clinical outcomes in non-HIV Pneumocystis jirovecii pneumonia patients.BMC pulmonary medicine · 2025Article
- Epidemiology and Clinical Relevance ofJournal of clinical medicine · 2025Article
18 more citing papers are in PubMed but not listed here.
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11 authors.
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Abstract
backgroundDespite modern intensive care with standardized strategies against acute respiratory distress syndrome (ARDS), Pneumocystis pneumonia (PcP) remains a life-threatening disease with a high mortality rate. Here, we analyzed a large mixed cohort of immunocompromised patients with PcP, with regard to clinical course and treatment, and aimed at identifying predictors of outcome.
methodsThis was a single-center retrospective analysis in a tertiary care institution across 17 years. Diagnosis of PcP required typical clinical features and microbiological confirmation of Pneumocystis jirovecii. Epidemiological, clinical, laboratory and outcome data were collected from patient records.
resultsA total of 52,364 specimens from 7504 patients were sent for microbiological assessment (3653 with clinical suspicion of Pneumocystis pneumonia). PcP was confirmed in 240 patients, about half of them HIV positive (52%). The remaining subjects were either solid organ transplant recipients (16.3%) or suffered from malignancy (15.8%) or autoimmune diseases (11.7%). Of note, 95% of patients with PcP were not receiving chemoprophylaxis. Overall in-hospital mortality was 25.4%, increasing to 58% if ICU admission was required. Multivariable regression identified lactate dehydrogenase (LDH) as predictor of in-hospital mortality (adjusted OR 1.17 (95% CI 1.09-1.27), p < 0.0001). Mortality in LDH quartiles increased from 8% to 49%, and a cutoff value of 495 U/L predicted mortality with sensitivity and specificity of 70%. With regard to treatment, 40% of patients received trimethoprim-sulfamethoxazole at doses that were lower than recommended, and these patients had a higher mortality risk (HR 1.80 (95% CI 1.10-3.44), p = 0.02).
conclusionsPcP remains a life-threatening disease among immunocompromised patients. About half of patients with PcP do not have HIV infection. Initial LDH values might serve as a stratifying tool to identify those patients at high risk of death among patients with HIV and without HIV infection.
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