Characteristics and outcome according to underlying disease in non-AIDS patients with acute respiratory failure due to Pneumocystis pneumonia - Archive ouverte HAL Access content directly
Journal Articles European Journal of Clinical Microbiology and Infectious Diseases Year : 2021

Characteristics and outcome according to underlying disease in non-AIDS patients with acute respiratory failure due to Pneumocystis pneumonia

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Lucie Biard
  • Function : Author
Antoine Roux
  • Function : Author
Sandrine Valade
Florence Robert-Gangneux
Daniéle Maubon
  • Function : Author
Anne Debourgogne
  • Function : Author
  • PersonId : 762432
  • IdRef : 135395410
Soléne Le Gal
  • Function : Author
Fréderic Dalle
  • Function : Author
Marion Leterrier
  • Function : Author
Dominique Toubas
  • Function : Author
Christelle Pomares
  • Function : Author
Julie Bonhomme
  • Function : Author
Antoine Berry
Xavier Iriart
  • Function : Author
  • PersonId : 994510
Isabelle Durand-Joly
  • Function : Author
Denis Magne
  • Function : Author
Denis Pons
  • Function : Author
Christophe Hennequin
  • Function : Author
Eric Maury
  • Function : Author
Elie Azoulay
  • Function : Author
Virginie Lemiale
  • Function : Author

Abstract

In the non-AIDS group, several underlying conditions and immune defects could lead to different PCP presentations. This study compared PCP presentation and outcome according to the underlying disease. A secondary analysis of a previously published prospective observational study including 544 PCP patients was done. Only non-AIDS patients were included. Underlying disease was defined as chronic lymphocytic leukemia (CLL), organ transplantation, solid cancer, allogeneic hematopoietic stem cell transplant (AHSCT), other hematological diseases, and immunosuppressive treatment. Clinical characteristics and outcomes were compared between groups. Multiple correspondent analyses compared clinical characteristics at diagnosis. Day 30 mortality was analyzed. Three hundred and twenty-one patients were included in the study. The underlying diseases were hematological malignancy (n = 75), AHSCT (n = 14), CLL (n = 19), solid organ transplant (n = 94), solid tumor (n = 39), and immunosuppressive treatment (n = 57). Compared with other underlying diseases, PCP related to CLL was closer to PCP related to AIDS presentation (long duration of symptoms before diagnosis, high level of dyspnea, and low oxygen saturation at diagnosis). Day 30 mortality was associated with underlying disease, oxygen flow, and shock at ICU admission. PCP presentations may vary according to the underlying reason for immunosuppression. Response to treatment and adjuvant steroid therapy should be analyzed regarding this result.

Dates and versions

hal-03528100 , version 1 (17-01-2022)

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Cite

Gaston Burghi, Lucie Biard, Antoine Roux, Sandrine Valade, Florence Robert-Gangneux, et al.. Characteristics and outcome according to underlying disease in non-AIDS patients with acute respiratory failure due to Pneumocystis pneumonia. European Journal of Clinical Microbiology and Infectious Diseases, 2021, 40 (6), pp.1191-1198. ⟨10.1007/s10096-020-04118-w⟩. ⟨hal-03528100⟩
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