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Clinical prognostic factors for pneumocystis pneumonia in non-HIV patients

Koji Tamai, Ryo Tachikawa, Takahisa Kawamura, Kazuya Monden, Takeshi Matsumoto, Junpei Takeshita, Kosuke Tanaka, Kazuma Nagata, Kyoko Otsuka, Atsushi Nakagawa, Kojiro Otsuka, Keisuke Tomii
European Respiratory Journal 2012 40: P1919; DOI:
Koji Tamai
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Ryo Tachikawa
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Takahisa Kawamura
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Kazuya Monden
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Takeshi Matsumoto
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Junpei Takeshita
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Kosuke Tanaka
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Kazuma Nagata
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Kyoko Otsuka
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Atsushi Nakagawa
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Kojiro Otsuka
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Keisuke Tomii
1Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Abstract

Introduction: Non-HIV patients with Pneumocystis pneumonia (PCP) has poor prognosis. Improved knowledge of presenting symptoms and prognostic factors for non-HIV PCP may help to reduce its associated high mortality rate.

Aims: To describe the characteristics of PCP in non-HIV patients and to identify prognostic factors.

Methods: We retrospectively reviewed non-HIV PCP patients between April 2006 and July 2011. Demographics, laboratory findings and their prognosis were evaluated.

Results: A total of 33 non-HIV PCP patients were analyzed. Of these, 15 patients (45.5%) died. BAL was performed in 26 patients and was successfully done in 10 of them under non-invasive positive pressure ventilation. Pneumocystis PCR in BAL specimens yielded the high positive ratio of 96.2%. There was no serious adverse events associated BAL procedure. Cox proportional hazards model revealed C reactive protein (CRP) and BAL neutrophilia were significant prognostic factors determining 30-day mortality. Logrank test showed patients with higher CRP (≥7 mg/dL) and BAL neutrophilia (≥16%) had significant lower survival rates (p=0.003, p=0.0048, respectively).

Conclusions: CRP and BAL neutrophilia were identified as significant predictors of survival in patients with non-HIV PCP. Our data also emphasize significance of performing BAL in these patients since it provides important prognostic information.

  • Immunosuppression
  • Pneumonia
  • Infections
  • © 2012 ERS
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Clinical prognostic factors for pneumocystis pneumonia in non-HIV patients
Koji Tamai, Ryo Tachikawa, Takahisa Kawamura, Kazuya Monden, Takeshi Matsumoto, Junpei Takeshita, Kosuke Tanaka, Kazuma Nagata, Kyoko Otsuka, Atsushi Nakagawa, Kojiro Otsuka, Keisuke Tomii
European Respiratory Journal Sep 2012, 40 (Suppl 56) P1919;

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Clinical prognostic factors for pneumocystis pneumonia in non-HIV patients
Koji Tamai, Ryo Tachikawa, Takahisa Kawamura, Kazuya Monden, Takeshi Matsumoto, Junpei Takeshita, Kosuke Tanaka, Kazuma Nagata, Kyoko Otsuka, Atsushi Nakagawa, Kojiro Otsuka, Keisuke Tomii
European Respiratory Journal Sep 2012, 40 (Suppl 56) P1919;
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