Pneumocystis jirovecii and Cytomegalovirus Co-Infection in AIDS Patients

Joana Acar, Germana da Rocha Torres, Johanna Wagner Poti Sales, Bruna Leite Marques, Renato Azambuja, Luiz Carlos Aguiar Vaz, Claudia Henrique da Costa, Rogerio Rufino


A case report of a young woman with insidious dyspnea, cough and weight loss that began 3 months before hospitalization. She referred to occasional cough, wheezing, and fever during the last 2 years. Over one year before, she performed a chest CT that showed diffuse ground-glass opacity (GGO) distributed in both lungs with predominance in the upper and middle areas. She immediately received standardized treatment with sulfamethoxazole-trimethoprim (SMZ-TMP), and ELISA and Western Blot tests for AIDS were performed, and both were positive. Pneumocystis Jirovecci (PCJ) staining and PCR from bronchoalveolar lavage were negative. The GGO seen in CT was inconclusive. After 10 days of treatment, she progressed to being respiratory insufficient. A lung biopsy was done and revealed co-infection of cytomegalovirus (CMV) and PCJ. Although first line therapy for both PCJ and CMV was instituted early, she had an unfavorable outcome. Despite following the recommendations for diagnosis and treatment of community-acquired pneumonia in immunosuppressed patients, the patient died. The use of molecular biomethods for recognizing sulfur resistance is not usually performed in daily practice and an old question regarding the aggressiveness of co-infection of PCJ and CMV returned in this case.

J Med Cases. 2013;4(6):402-406


Pneumocystis pneumonia; Pneumocystosis; Acquired immunodeficiency syndrome; Cytomegalovirus; Ground-glass opacity; Oral candidiasis

Full Text: HTML PDF

Browse  Journals  


Journal of Clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics


World Journal of Oncology

Gastroenterology Research

Journal of Hematology


Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity


Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research


Journal of Neurology Research

International Journal of Clinical Pediatrics



Journal of Medical Cases, monthly, ISSN 1923-4155 (print), 1923-4163 (online), published by Elmer Press Inc.                     
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)

This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website:   editorial contact:
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.

Disclaimer: The views and opinions expressed in the published articles are those of the authors and do not necessarily reflect the views or opinions of the editors and Elmer Press Inc. This website is provided for medical research and informational purposes only and does not constitute any medical advice or professional services. The information provided in this journal should not be used for diagnosis and treatment, those seeking medical advice should always consult with a licensed physician.