Background: A recent database study and meta-analysis reported that adjunctive glucocorticoid therapy reduces mortality in patients with non-human immunodeficiency virus-associated (non-HIV) Pneumocystis jirovecii pneumonia (PCP), having hypoxemia. However, the optimal glucocorticoid dose remains unclear. Our study aimed to evaluate the effectiveness of pulse methylprednisolone compared with mild-to-moderate steroid doses in patients with non-HIV PCP.
View Article and Find Full Text PDFIntravascular large B-cell lymphoma (IVLBCL) typically involves nonspecific symptoms that complicate diagnosis. This report discusses the case of a 70-year-old man, who presented with dyspnea, fatigue, and weight loss that evolved into severe respiratory failure, diagnosed with IVLBCL via random skin biopsy. The initial improvement in respiratory symptoms was followed by coronavirus disease.
View Article and Find Full Text PDFBackground: To investigate the outcomes of Pneumocystis jirovecii pneumonia (PCP) between patients with rheumatoid arthritis (RA) treated with and without biologics before PCP onset.
Patients And Methods: We retrospectively included rheumatoid arthritis (RA) patients with PCP treated with and without biologics before PCP onset. The primary endpoints were 30-day and 180-day survival rates, and the secondary endpoint was severe PCP, including in-hospital death, intensive care unit admission, and requirement of respiratory support during hospitalization.
Background: In flexible bronchoscopy, endobronchial ultrasonography using a guide sheath (EBUS-GS) has varying diagnostic yield depending on the findings of radial-endobronchial ultrasonography (R-EBUS). The diagnosis rate is lower when the ultrasound probe is "adjacent to", than when it is "within" the lesion. However, these findings are inconsistent, and the imaging status may change from "adjacent to" to "within" as examination progresses.
View Article and Find Full Text PDFis a gram-positive anaerobic coccus (GPAC) that colonizes the oral cavity and gastrointestinal tract. Recent advances in bacterial identification have confirmed the clinical importance of . Here, we report a case of empyema with bacteremia caused by .
View Article and Find Full Text PDFBackground: Trimethoprim-sulfamethoxazole (TMP-SMX) is an effective treatment for Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients with and without HIV infection; however, a high incidence of adverse events has been observed. Low-dose TMP-SMX is a potentially effective treatment with fewer adverse events; however, evidence is limited.
Research Question: What is the efficacy and safety of low-dose TMP-SMX for non-HIV PCP compared with conventional-dose TMP-SMX after adjusting for patient background characteristics?
Study Design And Methods: In this multicenter retrospective cohort study, we included patients diagnosed with non-HIV PCP and treated with TMP-SMX between June 2006 and March 2021 at three institutions.
An 83-year-old man presented with chronic dyspnea, and chest X-ray showed bilateral pleural effusion. Right thoracentesis revealed lymphocyte-predominant exudate with no malignancy; bacterial and mycobacterial cultures were negative. Thoracoscopy via the right chest and a biopsy of the same site were performed; these showed lymphoplasmacytic infiltration and fibrosis, ruling out malignancy or tuberculosis.
View Article and Find Full Text PDF