Clinical Features and Outcomes in a Case Series of Pediatric Patients with Pneumocystis Pneumonia
Abstract
Pneumocystis jirovecii pneumonia (PJP) is a frequent infectious complication in immunocompromised pediatric patients in the absence of trimethoprim/sulfamethoxazole prophylaxis. The aim of this case series was to describe the clinical, radiologic features as well as outcomes of pediatric patients with PJP.
Cases diagnosed as PJP with a positive real-time PCR for P. jirovecii DNA in bronchoalveolar lavage (BAL) between January 2023 and November 2024 in a third level hospital (Instituto Nacional de Pediatría) in Mexico City were included in this study. Clinical and radiological information was obtained from electronic records.
Sixteen patients were identified with a median age of 12.9 years. The most frequent underlying disease was Acute Lymphoblastic Leukemia (ALL) (31.3%), followed by solid tumors (ST) and inborn immune errors (IIE) (18.8% each). Steroid therapy was present before diagnosis in 68.8%, and 62.5% were lymphopenic (<1000 cells/mm3) with a median duration of 11 days. None of the patients in the case-series had received trimethoprim/sulfamethoxazole prophylaxis before diagnosis.
For the clinical presentation patients presented 4.5 days (1 - 14) after symptoms started. The most frequent signs at admission were respiratory distress (68.8%) and hypoxemia (56.3%). Half of patients had fever, cough and dyspnea. 50% developed a severe disease and 56.3% required mechanical ventilation. 93.8% patients had a chest X-ray at diagnosis and 37.5% had a chest CT scan.…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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