[Ventilator-associated pneumonia caused by Pneumocystis carinii in the non-human immunodeficiency virus infection: a report of 5 cases].

OBJECTIVE

To comprehend ventilator-associated pneumonia (VAP) caused by pneumocystis carinii (P. carinii-VAP) in the non-human immunodeficiency virus (HIV) infected patients.

METHODS

The clinical data of 5 patients with P. carinii-VAP in the non-HIV patients from 2000 to 2003 in our hospital were reviewed.

RESULTS

Five male patients, aged 71 - 93, had severe predisposing diseases and respiratory failure induced by lung infection. All patients were treated with mechanical ventilation and multiple antibiotics and had recurrent VAP. Fever was present in all patients together with respiratory symptoms. Moist rales were noted in four of them. X-ray showed diffuse patchy shadows in 4 patients, extensive densities in 1 cases, reticular infiltrations in 2 cases, and pleural effusion in 2 cases. Sputum P. carinii was found by smear staining in 4 cases as well as a positive PC PCR. The remaining case only showed a positive PC PCR. Four patients were cured after treatment with SMZco, but one patient died.

CONCLUSION

P. carinii-VAP could occur during prolonged mechanical ventilation for severe respiratory diseases, particularly in aged patients with advanced cancer or treated with glucocorticoids and broad spectrum antibiotics.