| Title |
Pneumocystis jirovecii pneumonija ir agranulocitozė: klinikinis atvejis ir literatūros apžvalga / |
| Translation of Title |
Pneumocystis jirovecii pneumonia and agranulocytosis: a case report and literature review. |
| Authors |
Noreikaitė, Eglė ; Paulauskas, Mindaugas |
| DOI |
10.53453/ms.2025.4.5 |
| Full Text |
|
| Is Part of |
Medicinos mokslai = Journal of medical sciences.. Kėdainiai : VšĮ Lietuvos sveikatos mokslinių tyrimų centras. 2025, vol. 13, iss. 2, p. 38-43.. ISSN 2345-0592 |
| Keywords [eng] |
AIDS ; pneumocystis jirovecii ; pneumonia ; agranulocytosis ; TMP/SMX |
| Abstract [eng] |
Background. Pneumocystis jirovecii pneumonia is an opportunistic infection that occurs in immunosuppressed patients with AIDS. Despite the decreasing number of cases due to the use of antiretroviral drugs and prophylaxis, pneumocystis pneumonia remains a life-threatening infection, affecting around 15% of HIV patients. The most effective drugs for its treatment, trimethoprim and sulfamethoxazole, have a myelosuppressive effect which can rarely lead to infectious complications. Case presentation. We present the clinical case of a 50-year-old woman who was recently diagnosed with HIV infection, complaining of shortness of breath, weakness and fever. The patient was diagnosed with pneumocystis pneumonia and was treated with trimethoprim and sulfamethoxazole (TMP/SMX). During the course of treatment, agranulocytosis, pancytopenia and sepsis developed. After discontinuing myelosuppressive drugs (trimethoprim and sulfamethoxazole, azathioprine) and administrating antibiotics and filgrastim, the patient's condition improved, clinical symptoms and agranulocytosis resolved. Conclusions. The etiology of neutropenia in HIV positive patients is complex and includes HIV cytotoxicity, secondary infections and the effects of myelosuppressive drugs used in treatment. The combination of trimethoprim and sulfamethoxazole effectively treats pneumocystis pneumonia, but its myelosuppressive side effects should be considered, especially in combination with other drugs. Since immunosuppressed patients who require additional immunosuppressive treatment are often encountered in clinical practice, it is important to monitor the dynamics of laboratory tests and clinical symptoms and promptly discontinue drugs with dangerous side effects. |
| Published |
Kėdainiai : VšĮ Lietuvos sveikatos mokslinių tyrimų centras |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2025 |
| CC license |
|
