Pneumocystis jirovecii and Mycobacterium tuberculosis Pulmonary Coinfection in an HIV-Seronegative Patient: A Case Report and Literature Review

Abstract

Shanchen Wei, Lianjun Lin Geriatric Department, Peking University First Hospital, Beijing, 100034, People’s Republic of ChinaCorrespondence: Lianjun Lin, Geriatric Department, Peking University First Hospital, Xicheng District, Beijing, 100034, People’s Republic of China, Email [email protected]: Coinfection with Pneumocystis jirovecii and Mycobacterium tuberculosis is rare in HIV-seronegative patients. Because it is associated with unknown morbidity and a high mortality rate especially in patients with immunosuppression, health care practitioners should have a high index of suspicion when dealing with such patients.Case Presentation: A 66-year-old man with glucocorticoid therapy for 9 years had a fever after getting a cold and developed respiratory failure rapidly within 3 days. He was given trimethoprim-sulfamethoxazole empirically before Pneumocystis pneumonia (PCP) was confirmed with the presence of cysts in the sputum. Although there was a partial improvement of symptoms, an area of consolidation on the left upper lung lobe gradually enlarged. Bronchoscopy was performed 3 times and Mycobacterium tuberculosis infection was finally diagnosed. For 1 years, he was treated with standard antituberculosis agents, and his psychological well-being was managed using traditional Chinese medicine techniques. After 3 years of follow-up, his outcome was very good.Conclusion: HIV-seronegative patients on long-term glucocorticoid therapy in areas with a high incidence of Mycobacterium tuberculosis may be co-infected with Pneumocystis jirovecii. When opportunistic infections are suspected, diagnostic procedures including invasive ones should be performed as soon as possible and appropriate interventions need to be carried out promptly.Keywords: Mycobacterium tuberculosis, Pneumocystis jirovecii, PCP, HIV-seronegative, Immunosuppressed, corticosteroids

Keywords

• mycobacterium tuberculosis
• pneumocystis jirovecii
• pcp
• hiv-seronegative
• immunosuppressed
• corticosteroids