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ORIGINAL ARTICLE
Year : 2018  |  Volume : 18  |  Issue : 4  |  Page : 112-115

Risk factors, clinical manifestations, and outcomes of Pneumocystis jirovecii infection in post-renal transplant recipients


Department of Nephrology, Mahatma Gandhi Hospital, Jaipur, India

Correspondence Address:
Dr. Jitesh Jeswani
Senior Resident in Nephrology Mahatma Gandhi Hospital, Jaipur - 302022
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jesnt.jesnt_30_18

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Introduction Pneumocystis jirovecii pneumonia (PJP) is a potentially life-threatening infection that occurs in immunocompromised patients. A timely diagnosis of PJP is difficult and relies on clinical features, imaging, and detection of the organism. The aim of this study was to evaluate the risk factors, clinical presentation, and outcomes for 15 patients who developed PJP infection. Patients and methods A retrospective clinical study included all 578 kidney transplant patients who underwent kidney transplantation at the Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan. Of the 578 patients, 15 patients developed PJP infection. Results The median age of all recipients was 55.3 years. The mean duration of prophylaxis was 6.9 months (range: 3–9 months). Only one patient had cytomegalovirus infection, and eight patients had a history of graft rejection. Most of our patients had fever and cough as the presenting symptoms, and all patients had breathlessness on admission. Bilateral haziness seen on chest radiograph was present in seven patients, and 10 patients had bilateral ground-glass appearance on high-resolution computed tomography scan. PCR finding for PJP was positive in all patients. Mortality was seen in four patients, where all the four cases had received anti-rejection therapy with ATG. Conclusion We concluded that among renal transplant recipients, PJP can still occur several months after transplantation, late after prophylaxis discontinuation. Treatment with anti-rejection therapy appears to be the major risk factor for PJP in these patients.


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