Acute and Critical Care

Case Reports

Infection/Cardiology
Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome following HAART Initiation in an HIV-infected Patient Being Treated for Severe Pneumocystis jirovecii Pneumonia: Case Report and Literature Review: Dong Won Park, Dae Hyun Lim, Bongyoung Kim, Ji Young Yhi, Ji-Yong Moon, Sang-Heon Kim, Tae-Hyung Kim, Jang Won Shon, Ho Joo Yoon, Dong Ho Shin, Hyunjoo Pai; Korean J Crit Care Med. 2016;31(2):162-168. Published online May 31, 2016; DOI: https://doi.org/10.4266/kjccm.2016.31.2.162

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Pnuemocystis jirovecii pneumonia (PJP) is one of leading causes of acute respiratory failure in patients infected with human immunodeficiency virus (HIV), and the mortality rate remains high in mechanically ventilated HIV patients with PJP. There are several reported cases who received extracorporeal membrane oxygenation (ECMO) treatment for respiratory failure associated with severe PJP in HIV-infected patients. We report a patient who was newly diagnosed with HIV and PJP whose condition worsened after highly active antiretroviral therapy (HAART) initiation and progressed to acute respiratory distress syndrome requiring veno-venous ECMO. The patient recovered from PJP and is undergoing treatment with HAART. ECMO support can be an effective life-saving salvage therapy for acute respiratory failure refractory to mechanical ventilation following HAART in HIV-infected patients with severe PJP.

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Extracorporeal life support for immune reconstitution inflammatory syndrome in HIV patients with Pneumocystis jirovecii pneumonia
Kollengode Ramanathan, Julian K. Svasti, Graeme MacLaren
Journal of Artificial Organs.2018; 21(3): 371. CrossRef

Pneumocystis jiroveci Pneumonia in a 5-month-old Boy with Agammaglobulinemia: A Case Report: Bo Hyun Chung, Hyo Kyoung Nam, Young Jun Rhie, Kwang Chul Lee, Ji Tae Choung, Choon Hak Lim, Young Yoo; Korean J Crit Care Med. 2012;27(4):274-278.; DOI: https://doi.org/10.4266/kjccm.2012.27.4.274

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Abstract PDF: Pneumocystis jiroveci (P. jiroveci) pneumonia is known as a common opportunistic infection in patients with impaired immunity. Underlying disease or conditions related to the development of P. jiroveci pneumonia include acquired immunodeficiency syndromes, as well as malignancies and congenital immune deficiency disorders. We describe a 5-month-old boy without significant medical history who was admitted at our hospital because of fever, tachypnea, vomiting, diarrhea, and lethargy whose condition became worse within several hours after admission. A chest X-ray showed bilateral diffuse infiltration and high resolution computed tomography showed diffuse bilateral ground-glass opacity. The patient was diagnosed with P. jiroveci pneumonia by direct immunofluorescent antibody staining from lung biopsy and he was later diagnosed with agammaglobulinemia. Although the boy was treated with antibiotics, high-dose corticosteroids and mechanical ventilation, he expired on the 5th hospital day. Here, we report the case of P. jiroveci pneumonia in a boy with agammaglobulinemia.

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