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.
- © 2012 ERS
