Extracorporeal Membrane Oxygenation for Pneumocystis jirovecii Pneumonia in a Child With Multisystem Langerhans Cell Histiocytosis.
Vivek Mohan, Sanjay Kumar, Akashneel Bhattacharya et al.
✦ AI-curated · Sources linked
Case in brief
A 3-year-old boy with multisystem Langerhans cell histiocytosis developed severe Pneumocystis jirovecii pneumonia during treatment. Despite high-dose trimethoprim-sulfamethoxazole and invasive mechanical ventilation, he experienced refractory respiratory failure. Venovenous ECMO was initiated, leading to rapid improvement in gas exchange, decannulation by day 6, and extubation by day 8. The child completed treatment and remains well at 10-month follow-up.
Diagnostic / clinical pearl
Early recognition and aggressive supportive care are crucial in managing severe Pneumocystis jirovecii pneumonia, especially in immunocompromised children.
Why it matters
This case highlights the potential role of venovenous ECMO as a lifesaving intervention in selected patients with isolated respiratory failure due to PJP.