Echinocandins for Pneumocystis jirovecii pneumonia in non-HIV patients: A case report

Abstract

For the past two decades, echinocandins have shown prophylactic and therapeutic efficacy in patients with Pneumocystis jirovecii pneumonia (PJP), due to their ability to inhibit the synthesis of β-1, 3-glucan, a major component of the cell wall of P. jirovecii. The present study reported two cases of human immunodeficiency virus (HIV)-negative patients who received echinocandins as a salvage therapy at Peking Union Medical College Hospital (Beijing, China), both of whom exhibited good responses to treatment. In both cases, polymerase chain reaction of sputum or bronchoalveolar lavage specimens became negative following treatment. The present study also performed a literature search to identify non-HIV patients with PJP who previously received echinocandins. The results of the present study suggested that echinocandins maybe promising therapeutic agents in the treatment of non-HIV patients with PJP, particularly in combination with trimethoprim-sulfamethoxazole. Therefore, the results warrant a randomized controlled trial.

Keywords: Pneumocystis jirovecii pneumonia; echinocandins; non-human immunodeficiency viruspatients.

Figure 1.

Results of chest computed tomography scans. (A) Chest computed tomography revealed GGO (white arrow) of lung fields with pleural effusion (black arrow) in Case 1. (B) GGO dissapearedfollowingtreatment of case 1 with caspofungin. (C) GGO were found in both lungs in Case 2. (D) GGO of case 2 were absorbed followingtreatment with caspofungin. GGO, ground-glass opacity.