Pneumocystis carinii pneumonia in renal-transplant recipients treated with cyclosporine and steroids

J Infect Dis. 1984 Feb;149(2):143-7. doi: 10.1093/infdis/149.2.143.

Abstract

Fourteen of 156 renal-transplant recipients treated with cyclosporine and steroids developed Pneumocystis carinii-related pneumonia (PCP) over a 19-month period. This was a significant change from past experience with this disease in renal-transplant patients receiving azathioprine and steroids (six cases among 179 patients from 1977 to 1981). Epidemiological investigation failed to implicate either person-to-person or nosocomial spread of infection. Cases of PCP occurred more frequently in males. Twelve patients (86%) had onset of disease in the third or fourth months after transplantation. Comparison of cases to matched controls revealed that the cases had received lower doses of steroids and had a higher incidence of cytomegalovirus infection. This suggested that the cases may have been more effectively immunosuppressed than the controls. After institution of prophylaxis with trimethoprim-sulfamethoxazole, no further cases of PCP developed.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cyclosporins / administration & dosage
  • Cyclosporins / therapeutic use*
  • Cytomegalovirus Infections / immunology
  • Drug Combinations / therapeutic use
  • Female
  • Humans
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Pneumonia, Pneumocystis / drug therapy
  • Pneumonia, Pneumocystis / immunology*
  • Pneumonia, Pneumocystis / transmission
  • Risk
  • Sex Factors
  • Steroids / administration & dosage
  • Steroids / therapeutic use*
  • Sulfamethoxazole / therapeutic use
  • Trimethoprim / therapeutic use
  • Trimethoprim, Sulfamethoxazole Drug Combination

Substances

  • Cyclosporins
  • Drug Combinations
  • Steroids
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Trimethoprim
  • Sulfamethoxazole