Pneumocystis jirovecii pneumonia in a non-HIV immunocompromised patient presenting with bilateral pneumothoraces.
Neil Alden Yee Tan, Joel Marquez Santiaguel
✦ AI-curated · Sources linked
Case in brief
A non-HIV immunocompromised patient developed Pneumocystis jirovecii pneumonia (PJP) after prolonged corticosteroid therapy, initially presenting with dyspnoea and fever. Imaging revealed bilateral pneumothoraces alongside ground-glass opacities. Despite antimicrobial treatment and pleural drainage, the patient experienced complications including persistent air leak and ventilator-associated pneumonia, ultimately leading to death.
What made this case unusual
The case is notable for the occurrence of bilateral pneumothoraces as a rare and life-threatening complication of PJP in a non-HIV immunocompromised patient.
Diagnostic / clinical pearl
Clinicians should maintain a high index of suspicion for PJP in non-HIV immunocompromised patients, especially those on corticosteroids, as early recognition is crucial for management.
Why it matters
This case emphasizes the need for consideration of prophylaxis and prompt assessment for structural complications in high-risk patients to enhance clinical outcomes.