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Verstockt, B., Van Hemelen, M., Outtier, A., Sabino, J., Van Wijngaerden, E., De Munter, P., et al. (2020) Invasive Nocardiosis, Disseminated Varicella Zoster Reactivation, and Pneumocystis jiroveci Pneumonia Associated with Tofacitinib and Concomitant Systemic Corticosteroid Use in Ulcerative Colitis. Journal of Gastroenterology and Hepatology, 35, 2294-2297. https://doi.org/10.1111/jgh.15256

has been cited by the following article:

• TITLE: A 60-Year-Male Post Corneal Transplantation with Acute Pneumonia

  AUTHORS: Chamanant Satjanon, Theerasuk Kawamatawong

  KEYWORDS: Pneumocystis jiroveci Pneumonia, Nocardiosis., Cytomegalovirus (CMV), Corneal Transplantation, Acute Respiratory Failure, Glucocorticoid, Ground Glass Opacities, Brochoalveolar Lavage Fluid (BALF)

  JOURNAL NAME: Open Journal of Ophthalmology, Vol.11 No.1, February 5, 2021

  ABSTRACT: Pneumonia is a common complication in organ transplantation patients. Multiple respiratory pathogens such as bacteria, viruses and fungi are potentially coexisted. A 60-year-old male with left eye post corneal transplantation developed acute severe pneumonia caused by Pneumocystis jiroveci (PJP) coinfection with Nocardia spp. and Cytomegalovirus (CMV). He was hospitalized due to acute respiratory failure. Chest radiographs and chest Computed Tomography (CT) revealed extensive ground-glass opacities. PJP was diagnosed from Bronchoalveolar Lavage Fluid (BALF). The pneumonia was persistent despite of receiving intravenous cotrimoxazole. Tracheal aspirate showed faint gram-positive filamentous beaded branching organisms. Consequently Nocardia spp. was proven. Intravenous cotrimoxazole was continued and intravenous imipenem was added. After a course of dual antibiotics, pneumonia was gradually improved. A week after, he developed the worsened acute respiratory failure. The bronchoscopy was performed. The new pathogens were not detected from BALF microbiology. The BALF cytology was unremarkable. PJP was detected by Polymerase Chain Reaction (PCR) from BALF. CMV antigenemia was detected from BALF and blood. Intravenous ganciclovir was given. This report describes PJP coinfected with Nocardia spp. and CMV in post corneal transplantation patient suffering from severe pneumonia. Multiple respiratory pathogens are common among transplantation patients representing host immunosuppression and inadequate antimicorbial prophylaxis.