Pneumocystis jirovecii pneumonia secondary to chronic steroid use: An uncommon cause of pneumocystis pneumonia

Abstract

Patients on long-term immunosuppression, including corticosteroids or immunomodulatory drugs, are susceptible to opportunistic infections, such as like Pneumocystis jirovecii pneumonia (PJP). Corticosteroid use can increase the frequency of fungal infection, mask symptoms, and delay the diagnosis, and thus warrant preventive measures. Maintaining a high index of suspicion is important, and prophylactic antibiotics, particularly trimethoprim-sulfamethoxazole, should be considered for high-risk patients. This case underscores the diagnosis of PJP in a patient with interstitial lung disease receiving prolonged steroid therapy, despite lacking HIV and conventional risk factors for this infection. Notably, PJP can present as a more severe infection in non-HIV patients, leading to higher mortality rates and stressing the need for swift and effective diagnosis and treatment by healthcare providers.

Keywords: Pneumocystis jirovecii; pneumonia; chronic corticosteroid treatment use; fungal pneumonia; interstitial lung disease