Pneumocystis jiroveci pneumonia in non-HIV immunocompromised Taiwanese children

Background: Pneumocystis pneumonia (PCP) has been a common opportunistic infection in patients infected with human immunodeficiency virus (HIV). Up to the present, the burden of HIV infections predisposing to PCP is not a major concern in Taiwanese children. This paper describes our experience in dealing with 5 children with PCP in a tertiary children's center in northern Taiwan. Methods: We retrospectively reviewed cases by computer search of our hospital records with a diagnosis of PCP by microbiological or histological evidence of Pneumocystis jiroveci infection in patients younger than 18 years of age between January 1996 and December 2005 in the Chang Gung Children's Hospital. Results: A total of 5 patients with PCP were identified. Their ages ranged from 2 months to 14 years. The major underlying diseases were acute lymphoblastic leukemia (1 patient), severe combined immunodeficiency (SCID) (2), Langerhans cell histiocytosis (1), and systemic lupus erythematosis (1). None of the patients received regular chemoprophylaxis, 4 patients survived but 1 died from respiratory failure. Conclusions: From 1996 to 2005, PCP infections in Taiwanese children were commonly seen in primary immunodeficiency diseases, leukemia, or malignancies receiving cytotoxic and corticosteroid therapy. PCP in susceptible patients suggests non-compliance or underprescription of PCP chemoprophylaxis by the patients or in-charge physicians respectively.