PMID- 37877566
OWN - NLM
STAT- MEDLINE
DCOM- 20240110
LR  - 20240110
IS  - 1873-4251 (Electronic)
IS  - 1570-162X (Linking)
VI  - 21
IP  - 4
DP  - 2023
TI  - Coexistence of Cryptococcal Fungemia and Pneumocystis jirovecii Pneumonia in an 
      HIV-Infected Patient: A Case Report.
PG  - 259-263
LID - 10.2174/011570162X254084231016192302 [doi]
AB  - INTRODUCTION: Opportunistic infections caused by bacteria and fungi are common in 
      human immunodeficiency virus (HIV)-infected patients. Cryptococcus neoformans and 
      Pneumocystis jirovecii are the most common opportunistic infections in 
      immunosuppressed individuals, but their coexistence is rare. To our knowledge, 
      this is the first case presented in Turkey involving the coexistence of 
      C.neoformans fungemia and P.jirovecii pneumonia. CASE PRESENTATION: A 26-year-old 
      male patient presented with a cachectic appearance, cough, sputum, weakness, 
      shortness of breath, and a weight loss of 15 kg in the last three months. It was 
      learned that the patient was diagnosed with HIV three years ago, did not go to 
      follow-ups, and did not use the treatments. CD4 cell count was 7/mm3 (3.4%), CD8 
      cell count was 100 (54%) mm3, and HIV viral load was 5670 copies/mL. In thorax 
      computed tomography (CT), increases in opacity in diffuse ground glass density in 
      both lungs and fibroatelectasis in lower lobes were observed. With the 
      prediagnosis of P. jiroveci pneumonia, the HIV-infected patient was given 
      trimethoprim-- sulfamethoxazole 15 mg/kg/day intravenously (i.v.). On the 4th day 
      of the patient's hospitalization, mutiplex PCR-based rapid syndromic Biofire 
      (Film Array) blood culture identification 2 (BCID2) test (Biomerieux, France) was 
      applied for rapid identification from blood culture. C. neoformans was detected 
      in the blood culture panel. The treatment that the patient was taking with the 
      diagnosis of C. neoformans fungemia was started at a dose of liposomal 
      amphotericin B 5 mg/kg/- day + fluconazole 800 mg/day. CONCLUSION: While the 
      incidence of opportunistic infections has decreased with antiretroviral therapy 
      (ART), it remains a problem in patients who are unaware of being infected with 
      HIV or who fail ART or refuse treatment. High fungal burden, advanced age, low 
      CD4+ cell count, and being underweight are risk factors for mortality in 
      HIV-positive patients. Our case was a cachectic patient with a CD4 count of 7 
      cells/mm3. Despite the early and effective treatment, the course was fatal.
CI  - Copyright(c) Bentham Science Publishers; For any queries, please email at 
      epub@benthamscience.net.
FAU - Tatli Kis, Tuba
AU  - Tatli Kis T
AUID- ORCID: 0000-0001-6952-3748
AD  - Department of Infectious Diseases and Clinical Microbiology, Dr. Suat Seren Chest 
      Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
FAU - Yildirim, Suleyman
AU  - Yildirim S
AUID- ORCID: 0000-0001-9856-3431
AD  - Intensive Care Unit, Dr Suat Seren Chest Diseases and Thoracic Surgery Training 
      and Research Hospital, Izmir, Turkey.
FAU - Bicmen, Can
AU  - Bicmen C
AUID- ORCID: 0000-0001-5392-570X
AD  - Department of Medical Microbiology, Dr Suat Seren Chest Diseases and Thoracic 
      Surgery Training and Research Hospital, Izmir, Turkey.
FAU - Yucel, Nur
AU  - Yucel N
AUID- ORCID: 0000-0003-3758-6618
AD  - Department of Pathology, Dr Suat Seren Chest Diseases and Thoracic Surgery 
      Training and Research Hospital, Izmir, Turkey.
FAU - Kirakli, Cenk
AU  - Kirakli C
AUID- ORCID: 0000-0001-6013-7330
AD  - Intensive Care Unit, Dr Suat Seren Chest Diseases and Thoracic Surgery Training 
      and Research Hospital, Izmir, Turkey.
LA  - eng
PT  - Case Reports
PL  - Netherlands
TA  - Curr HIV Res
JT  - Current HIV research
JID - 101156990
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
SB  - IM
MH  - Male
MH  - Humans
MH  - Adult
MH  - *Pneumonia, Pneumocystis/complications/diagnosis/drug therapy
MH  - *HIV Infections/complications/drug therapy
MH  - HIV
MH  - *AIDS-Related Opportunistic Infections/complications/diagnosis/drug therapy
MH  - *Fungemia/complications/diagnosis/drug therapy
MH  - Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
OTO - NOTNLM
OT  - Cryptococcus neoformans
OT  - Pneumocystis jirovecii
OT  - antiretroviral therapy.
OT  - case report
OT  - co-infection
OT  - human immunodeficiency virus
EDAT- 2023/10/25 12:42
MHDA- 2024/01/10 06:41
CRDT- 2023/10/25 07:53
PHST- 2023/03/31 00:00 [received]
PHST- 2023/06/24 00:00 [revised]
PHST- 2023/09/12 00:00 [accepted]
PHST- 2024/01/10 06:41 [medline]
PHST- 2023/10/25 12:42 [pubmed]
PHST- 2023/10/25 07:53 [entrez]
AID - CHR-EPUB-135538 [pii]
AID - 10.2174/011570162X254084231016192302 [doi]
PST - ppublish
SO  - Curr HIV Res. 2023;21(4):259-263. doi: 10.2174/011570162X254084231016192302.