Successful treatment of severe pneumocystis pneumonia with clindamycin-primaquine in an HIV-negative patient.

Pneumocystis pneumonia is an increasingly recognized threat in non-HIV immunosuppressed patients and is associated with worse outcomes compared to HIV-infected patients. The preferred first line treatment is trimethoprim-sulfamethoxazole; however, second line treatments for those intolerant of this regimen have been primarily studied in patients with acquired immunodeficiency syndrome (AIDS). We report a case of Pneumocystis pneumonia in a 75-year-old man with chronic lymphocytic leukemia (CLL) and a history of sulfa allergy successfully treated with clindamycin-primaquine.

Clinical review: critical care transport and austere critical care.

The development of modern intensive care units (ICUs) has allowed the survival of patients with advanced illness and injury, although at a cost of substantial infrastructure. Natural disasters and military operations are two common situations that can create critically ill patients in an environment that is austere or has been rendered austere. This has driven the development of two related strategies to care for these casualties.