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Review
. 2025 Jun;53(6):3000605251344140.
doi: 10.1177/03000605251344140. Epub 2025 Jun 14.

Post-COVID-19 severe Pneumocystis jirovecii pneumonia in a non-HIV and immunocompetent patient: A case report and literature review

Zhi-Yang Xu  1 , Wei Ouyang  1 , Jin-Liang Liu  1 , Wen-Jing Ye  1 , Feng Xu  1
Affiliations
Review

Post-COVID-19 severe Pneumocystis jirovecii pneumonia in a non-HIV and immunocompetent patient: A case report and literature review

Zhi-Yang Xu et al. J Int Med Res. 2025 Jun.

Abstract

Pneumocystis jirovecii is a ubiquitous opportunistic fungus that can cause life-threatening pneumonia. The clinical manifestations of pneumonia caused by severe acute respiratory syndrome coronavirus 2 and P. jirovecii are similar, posing a significant challenge in the diagnosis of P. jirovecii pneumonia or coronavirus disease 2019. Herein, we report a case of P. jirovecii pneumonia diagnosed through bronchoalveolar lavage and sputum smear analyses. The patient recovered successfully and was discharged following combination therapy with trimethoprim/sulfamethoxazole and corticosteroids. Early diagnosis and prompt treatment are of vital importance in managing P. jirovecii pneumonia, particularly in individuals with related risk factors for P. jirovecii pneumonia development.

Keywords: Coronavirus disease 2019 convalescence; Pneumocystis jirovecii pneumonia; case report; literature review; non-human immunodeficiency virus infection patients.

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Conflict of interest statement

Declaration of conflicting interestsThe authors have no competing interests to declare that are relevant to the content of this article.

Figures

Figure 1.
Figure 1.
Chest computed tomography immediately showed diffuse exudative changes in both lungs and thickening of the interlobular septum (day 3).
Figure 2.
Figure 2.
Chest computed tomography changes in pulmonary lesions of the patient (after 3 weeks of TMP/SMX treatment).
Figure 3.
Figure 3.
Chest computed tomography changes in pulmonary lesions of the patient (after 4 weeks of TMP/SMX treatment).
Figure 4.
Figure 4.
A flow diagram presenting the search and study selection strategy.
See this image and copyright information in PMC

References

    1. Donnelly JP, Chen SC, Kauffman CA, et al. Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis 2020; 71: 1367–1376. - PMC - PubMed
    1. Lagrou K, Chen S, Masur H, et al. Pneumocystis jirovecii disease: basis for the revised EORTC/MSGERC invasive fungal disease definitions in individuals without human immunodeficiency virus. Clin Infect Dis 2021; 72: S114–S120. - PMC - PubMed
    1. Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia. an official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med 2019; 200: e45–e67. - PMC - PubMed
    1. Fujieda K, Saito S, Tanaka A, et al. A case of late-onset organizing pneumonia following COVID-19 infection in a post-kidney transplant patient. CEN Case Rep 2024; 13: 346–350. - PMC - PubMed
    1. Niamatullah H, Nasir N, Jabeen K, et al. Post-COVID-19 Pneumocystis pneumonia cases from Pakistan: an observational study. Access Microbiol 2023; 5: acmi000406. - PMC - PubMed

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