[The treatment of pneumocystis Carinii pneumonia with caspofungin in elderly patients: a case report and literature review].

OBJECTIVE

To describe the treatment with caspofungin of pneumocystis Carinii pneumonia (PCP) in elderly patients.

METHODS

A 93 year old male patient with chronic obstructive pulmonary disease (COPD) and in mechanical ventilation for 25 months. PCP was diagnosed and treated with trimethoprim-sulphamethoxazole compound (SMZ/TMP) and caspofungin.

RESULTS

The diagnosis of PCP was confirmed by clinical features, radiographic abnormalities and sputum smear Giemsa stain PC (+) or PCR (+). SMZ/TMP was the first choice in treatment of PCP but caspofungin can be used in patients. SMZ/TMP had to be discontinued because of side effect or treatment failure. Caspofungin was effective and without any side effects in this patient.

CONCLUSIONS

PCP is one of opportunistic infections in elderly patient admitted for long term mechanical ventilation. SMZ/TMP is the first choice for treatment but caspofungin may be an alternative.