Clinical analysis of 5 children with lymphoma complicated with Pneumocystis jirovecii pneumonia
10.3760/cma.j.cn115356-20220419-00116
- VernacularTitle:儿童淋巴瘤合并耶氏肺孢子菌肺炎5例临床分析
- Author:
Nan ZHANG
1
;
Yanlong DUAN
;
Ling JIN
;
Jing YANG
;
Shuang HUANG
;
Meng ZHANG
;
Yonghong ZHANG
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童医院 儿童肿瘤中心肿瘤内科 儿童血液病与肿瘤分子分型北京市重点实验室 儿科重大疾病研究教育部重点实验室，北京 100045
- Keywords:
Lymphoma;
Children;
Pneumocystis jirovecii pneumonia;
Treatment
- From:
Journal of Leukemia & Lymphoma
2023;32(2):109-113
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical features of childhood lymphoma complicated with Pneumocystis jirovecii pneumonia (PJP).Methods:The clinical data, diagnosis and treatment of 5 children with lymphoma complicated with PJP admitted to Beijing Children's Hospital from January 2013 to April 2022 were retrospectively analyzed.Results:Among 5 patients, there were 3 males and 2 females, the median onset age was 7 years old; 4 cases were non-Hodgkin lymphoma and 1 case was Hodgkin lymphoma. Fever and cough occurred 5-18 months after chemotherapy; typical mosaic sign could be seen in 2 cases without pneumothorax and pleural effusion as well as other pathogenic infection; all 5 cases had hypoxemia; 4 cases were diagnosed by next-generation sequencing (NGS). The CD4/CD8 ratio decreased in all cases, and the median CD4 positive T-cell was 200/μl. Trimethoprim-sulfamethoxazole (TMP-SMZ) was irregularly used in 3 cases. During the treatment, all cases received mechanical ventilation, TMP-SMZ intravenously dripping combined with caspofungin, glucocorticoid and gamma globulin. All 5 cases of PJP were cured and there was no recurrent infection.Conclusions:Lymphoma children are susceptible to PJP due to immunocompromise caused by chemotherapy, and their condition progresses rapidly. When encountering fever, shortness of breath, severe lung symptoms and mild signs of children, it is necessary to improve the vigilance of PJP. NGS can help diagnosis, and TMP-SMZ should be actively treated and prevented. Early diagnosis and active treatment can achieve a good prognosis.
