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Article Dans Une Revue European Journal of Clinical Microbiology and Infectious Diseases Année : 2021

Characteristics and outcome according to underlying disease in non-AIDS patients with acute respiratory failure due to Pneumocystis pneumonia

Lucie Biard
  • Fonction : Auteur
Antoine Roux
  • Fonction : Auteur
Sandrine Valade
Florence Robert-Gangneux
Daniéle Maubon
  • Fonction : Auteur
Anne Debourgogne
  • Fonction : Auteur
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  • IdRef : 135395410
Soléne Le Gal
  • Fonction : Auteur
Fréderic Dalle
  • Fonction : Auteur
Marion Leterrier
  • Fonction : Auteur
Dominique Toubas
  • Fonction : Auteur
Christelle Pomares
  • Fonction : Auteur
Julie Bonhomme
  • Fonction : Auteur
Antoine Berry
Xavier Iriart
Isabelle Durand-Joly
  • Fonction : Auteur
Denis Magne
  • Fonction : Auteur
Denis Pons
  • Fonction : Auteur
Christophe Hennequin
  • Fonction : Auteur
Eric Maury
  • Fonction : Auteur
Elie Azoulay
Virginie Lemiale
  • Fonction : Auteur

Résumé

In the non-AIDS group, several underlying conditions and immune defects could lead to different PCP presentations. This study compared PCP presentation and outcome according to the underlying disease. A secondary analysis of a previously published prospective observational study including 544 PCP patients was done. Only non-AIDS patients were included. Underlying disease was defined as chronic lymphocytic leukemia (CLL), organ transplantation, solid cancer, allogeneic hematopoietic stem cell transplant (AHSCT), other hematological diseases, and immunosuppressive treatment. Clinical characteristics and outcomes were compared between groups. Multiple correspondent analyses compared clinical characteristics at diagnosis. Day 30 mortality was analyzed. Three hundred and twenty-one patients were included in the study. The underlying diseases were hematological malignancy (n = 75), AHSCT (n = 14), CLL (n = 19), solid organ transplant (n = 94), solid tumor (n = 39), and immunosuppressive treatment (n = 57). Compared with other underlying diseases, PCP related to CLL was closer to PCP related to AIDS presentation (long duration of symptoms before diagnosis, high level of dyspnea, and low oxygen saturation at diagnosis). Day 30 mortality was associated with underlying disease, oxygen flow, and shock at ICU admission. PCP presentations may vary according to the underlying reason for immunosuppression. Response to treatment and adjuvant steroid therapy should be analyzed regarding this result.

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Santé

Dates et versions

hal-03528100 , version 1 (17-01-2022)

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Citer

Gaston Burghi, Lucie Biard, Antoine Roux, Sandrine Valade, Florence Robert-Gangneux, et al.. Characteristics and outcome according to underlying disease in non-AIDS patients with acute respiratory failure due to Pneumocystis pneumonia. European Journal of Clinical Microbiology and Infectious Diseases, 2021, 40 (6), pp.1191-1198. ⟨10.1007/s10096-020-04118-w⟩. ⟨hal-03528100⟩
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