Abstract
Introduction: Pneumocystis pneumonia (PCP) could occur not only in HIV patients but in those with other causes of immunodeficiency.
Purpose and methods:To evaluate clinical presentation and prognostic factors of non-HIV PCP, we retrospectively reviewed all the patients with PCP without HIV. Patients' characteristics, underlying diseases, clinical course, performance status (PS) (ECOG), disease activities and the time from respiratory symptoms onset until the therapies were initiated in both survival and fatality groups were evaluated.
Results: A total of 33 patients were eligible in this study. Thirty-two patients (97%) had malignancies or rheumatic disease receiving chemotherapy or long-term steroids and/or immunosuppressive agents. Twenty-two patients out of 33 survived. Both the time between the initial visit or first examination and establishing a diagnosis (4.8 vs 10.8 days, p< 0.01) and the time between the initial visit and starting anti-PCP therapy (3.1 vs 12.8 days, p<0.01) are statistically much shorter in survival group than in fatality group. Twelve of the 14 (85.7%) patients who empirically received therapy before confirming diagnosis survived. Twenty-one of the 22 patients with inactive underlying disease survived. In contrast, 10 of the 11 patients with the active underlying disease died. In terms of PS, 24 patients (72.7%) had good PS (0-2). Eight (72.7%) of the 11 non-survivors had PS of 3-4. As for Lab, CRP, LDH and KL-6 values were higher and Alb/BUN was lower in the fatality group compared with the survival group.
Conclusion: We suggest that the timing when the anti-PCP therapy is started, patients' and PS and disease activity might correlate with outcomes.
- © 2011 ERS
