A Case of Successfully Treated Pneumocystis jiroveci Pneumonia in CMV-associated IgA Nephropathy / 감염과화학요법

ABSTRACT

A range of infections including cytomegalovirus (CMV) infections are associated with IgA nephropathy. Several reports have suggested that the risk of Pneumocystis infections is lower in the presence of preceding immunomodulating infections, such as a CMV infection. We report a patient with Pneumocystis jiroveci pneumonia (PJP) in CMV-associated IgA nephropathy, who was treated with trimethoprim/sulfamethoxazole and gancyclovir. A 52 year old man suffered from fever, chill and dyspnea for 2 days. He has taken low dose immunosuppressants (prednisolone, cyclophosphamide) for 3 months due to IgA nephropathy. PJP was confirmed by Chest CT and P.jiroveci PCR was performed from a bronchoalveolar lavage. His CMV serology was CMV-IgM/IgG(-/+) and CMV PCR (+), and his urine CMV culture was positive. The patient recovered completely from pneumonia after administering oral trimethoprim/sulfamethoxazole and intravenous ganciclovir, and his renal function and proteinuria improved.