Detection of Pneumocystis jirovecii in Patients with Severe COVID-19: Diagnostic and Therapeutic Challenges

Journal of Fungi

Yvon Ruch¹  Victor Gerber¹  François Danion¹  Valentin Greigert²  Veronique Lindner³  Julie Brunet⁴  Julie Denis⁴  Francis Schneider⁵  Thiên-Nga Chamaraux-Tran⁶  Walid Oulehri⁷ 

[1] CHU de Strasbourg, Service de Maladies Infectieuses et Tropicales, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France;Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO 63130, USA;Département de Pathologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Avenue Molière, CEDEX, 67098 Strasbourg, France;Laboratoire de Parasitologie et de Mycologie Médicale, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;Service de Médecine Intensive Réanimation, Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;Service d’Anesthésie-Réanimation Chirurgicale, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Avenue Molière, CEDEX, 67098 Strasbourg, France;Service d’Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;

关键词: pneumocystosis;    Pneumocystis jirovecii;    COVID-19;    SARS-CoV-2;    fungi;   

DOI  :  10.3390/jof7080585

来源: DOAJ

【 摘 要 】

Cases of Pneumocystis jirovecii pneumonia (PCP) in patients suffering from COVID-19 were described in patients with various comorbidities and outcomes. The diagnosis of PCP in these patients is difficult due to clinical and radiological similarities. We carried out this study in order to better describe potentially at-risk patients and their outcomes. We retrospectively analyzed all patients with a P. jirovecii PCR performed in bronchoalveolar lavage fluid, tracheal aspirate, or sputum within a month after the COVID-19 diagnosis. Fifty-seven patients with COVID-19 infection were tested for P. jirovecii. Among 57 patients with COVID-19, four patients had a concomitant positive P. jirovecii PCR. These four patients were elderly with a mean age of 78. Two patients were immunocompromised, and the two others presented only diabetes mellitus. Three patients presented an ARDS requiring transfer to the ICU and mechanical ventilation. All patients presented lymphocytopenia. Three patients had probable PCP, and one had proven PCP. All patients died within two months after hospital admission. These co-infections are rare but severe, therefore, PCP should be considered in case of worsening of the condition of patients with severe COVID-19.

【 授权许可】

Unknown