PMID- 30114992
OWN - NLM
STAT- MEDLINE
DCOM- 20190606
LR  - 20190606
IS  - 1758-1052 (Electronic)
IS  - 0956-4624 (Linking)
VI  - 29
IP  - 14
DP  - 2018 Dec
TI  - Nodular granulomatous Pneumocystis jiroveci pneumonia consequent to delayed 
      immune reconstitution inflammatory syndrome.
PG  - 1451-1453
LID - 10.1177/0956462418787603 [doi]
AB  - Although Pneumocystis jiroveci pneumonia (PCP) is a frequent manifestation of 
      acquired immune deficiency syndrome (AIDS), the granulomatous form is uncommon. 
      Here, we present an unusual case of granulomatous PCP consequent to immune 
      reconstitution inflammatory syndrome (IRIS) after highly active antiretroviral 
      therapy. A 36-year-old woman with human immunodeficiency virus (HIV) presented 
      with cough and dyspnea that were attributed to typical PCP associated with AIDS. 
      She was successfully treated with antibiotic, steroid, and antiretroviral 
      therapies. After six months, however, she presented with consolidating lung 
      lesions caused by bronchial obstruction from PCP granulomatous disease. Although 
      antibiotics were ineffective, the effectiveness of steroid therapy suggested a 
      diagnosis of granulomatous IRIS caused by persistent PCP antigens. Physicians 
      should strongly suspect PCP in HIV-positive patients with nodular lung lesions 
      and must remain aware that these lesions, if immune in origin, might not respond 
      to antimicrobial therapy.
FAU - Taeb, Abdalsamih M
AU  - Taeb AM
AUID- ORCID: 0000-0001-8884-0503
AD  - 1 Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical 
      School, Norfolk, VA, USA.
FAU - Sill, Joshua M
AU  - Sill JM
AD  - 1 Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical 
      School, Norfolk, VA, USA.
FAU - Derber, Catherine J
AU  - Derber CJ
AD  - 2 Division of Infectious Diseases, Eastern Virginia Medical School, Norfolk, VA, 
      USA.
FAU - Hooper, Michael H
AU  - Hooper MH
AD  - 1 Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical 
      School, Norfolk, VA, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20180816
PL  - England
TA  - Int J STD AIDS
JT  - International journal of STD & AIDS
JID - 9007917
RN  - 0 (Anti-Infective Agents, Urinary)
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
RN  - VB0R961HZT (Prednisone)
SB  - IM
MH  - Adult
MH  - Anti-Infective Agents, Urinary/therapeutic use
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Bronchoscopy
MH  - Female
MH  - Granuloma, Respiratory Tract/complications/*diagnosis
MH  - HIV Infections/complications/*drug therapy/microbiology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*complications/drug therapy
MH  - Immunocompromised Host
MH  - Lung/*diagnostic imaging
MH  - Pneumocystis carinii/immunology/*isolation & purification
MH  - Pneumonia, Pneumocystis/*diagnosis/drug therapy
MH  - Prednisone/therapeutic use
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
MH  - Trimethoprim, Sulfamethoxazole Drug Combination
OTO - NOTNLM
OT  - HIV
OT  - Pneumocystis jiroveci pneumonia
OT  - granulomatous Pneumocystis jiroveci pneumonia
OT  - immune reconstitution inflammatory syndrome
OT  - nodular Pneumocystis jiroveci pneumonia
EDAT- 2018/08/18 06:00
MHDA- 2019/06/07 06:00
CRDT- 2018/08/18 06:00
PHST- 2018/08/18 06:00 [pubmed]
PHST- 2019/06/07 06:00 [medline]
PHST- 2018/08/18 06:00 [entrez]
AID - 10.1177/0956462418787603 [doi]
PST - ppublish
SO  - Int J STD AIDS. 2018 Dec;29(14):1451-1453. doi: 10.1177/0956462418787603. Epub 
      2018 Aug 16.