[Cardiac arrest during serve Pneumocystis jiroveci infection in an immune-compromised patient after splenectomy].

Abstract

Background: Pneumocystis jiroveci (old name Pneumocystis carini) can cause severe pneumonia in immune-compromised patients, most commonly those who are HIV infected.

Case report: A 68-yr-old man, who eight years earlier had undergone trauma related splenectomy, was admitted to ITU after a cardiac arrest due to septic shock caused by unknown pathogen. He had been treated for three weeks with various antibiotics without improvement. On the second day after resuscitation, high concentration of lgM anti-Pneumocystis jivecii antibodies was found, and high-dose trimetoprim therapy was started and continued for two weeks, Further treatment was complicated by ventilator-associated pneumonia (Acinetobacter baumannii); the patient eventually recovered without any neurological sequelae, and was transferred to a low-dependency area after 4 weeks in ITU.

Conclusion: We conclude that Pneumocystis jiroveci infection should be suspected as a cause of severe pneumonia in splenectomised patients.