The crucial role of molecular testing to facilitate the diagnosis of pneumocystis pneumonia during pregnancy
- Author:
Chuan Hun DING
1
;
Hamidah YUSOFF
;
Najihan Abdul Samat Muttaqillah
;
Yee Loong TANG
;
Toh Leong TAN
;
Petrick PERIYASAM
;
Andrea Yu-Lin BAN
Author Information
1. Department of Medical Microbiology & Immunology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
- Publication Type:Case Report
- Keywords:
Co-trimoxazole;
Pneumocystis jirovecii;
pregnancy;
real-time PCR
- From:The Malaysian Journal of Pathology
2018;40(1):67-72
- CountryMalaysia
- Language:English
-
Abstract:
Pneumocystis pneumonia is an important human immunodeficiency virus (HIV)-associated opportunistic infection, and especially so in pregnant HIV-positive patients. We report a case of a 40-year-old woman in her first trimester of pregnancy who initially presented with acute gastroenteritis symptoms but due to a history of high-risk behaviour and the observation of oral thrush, she was worked up for HIV infection. Her retroviral status was positive and her CD4+ T cell count was only 8 cells/mL. She was also worked up for pneumocystis pneumonia due to the presence of mild resting tachypnoea and a notable drop in oxygen saturation (from 100% to 88%) following brief ambulation. Her chest radiograph revealed bilaterally symmetrical lower zone reticular opacities and Giemsa staining of her bronchoalveolar lavage (BAL) was negative for Pneumocystis jirovecii cysts. However, real-time P. jirovecii polymerase chain reaction (PCR) testing on the same BAL specimen revealed the presence of the organism. A course of oral co-trimoxazole plus prednisolone was commenced and her clinical condition improved.
