Pneumocystis jirovecii pneumonia 13 years post renal transplant following a recurrent cytomegalovirus infection

A.H. Muhammad Iqbal, S.K. Lim, K.P. Ng, L.P. Tan, Y.B. Chong,T.C. Keng. Pneumocystis jirovecii pneumonia 13 years post renaltransplant following a recurrent cytomegalovirus infection.Transpl Infect Dis 2012: 14: E23–E26. All rights reservedAbstract: Pneumocystis jirovecii (formerly Pneumocystis carinii)pneumonia (PCP) is a rare but serious infection that usuallyoccurs within a year after solid organ transplantation. PCP mayoccur after 1 year post transplantation, but the rate is reported tobe very low. Studies have shown an association betweencytomegalovirus (CMV) infection in solid organ transplantpatients and an increased risk of opportunistic infection. Thisincreased risk is thought to be a result of the immunomodulatoryeffects of the CMV infection. We present a case of PCP infectionoccurring 13 years after a renal transplantation. This occurredfollowing a recurrent CMV infection while the patient was on low-dose immunosuppressants.A.H. Muhammad Iqbal