Bone Marrow Infection by <i>Pneumocystis jirovecii</i> in a Patient with AIDS: A Case Report and Literature Review
Background: <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> primarily causes pneumonia in immunosuppressed individuals, particularly those living with advanced HIV/AIDS. Extrapulmonary dissemination is uncommon, with bone marrow involvement described in only a...
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2025-05-01
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| author | Diego Alejandro Cubides-Diaz Valentina Negrette-Lazaro Viviana Poveda-Hurtado Juan Pablo López-Salazar Carlos Mauricio Calderón-Vargas Carlos Arturo Álvarez-Moreno |
| author_facet | Diego Alejandro Cubides-Diaz Valentina Negrette-Lazaro Viviana Poveda-Hurtado Juan Pablo López-Salazar Carlos Mauricio Calderón-Vargas Carlos Arturo Álvarez-Moreno |
| author_sort | Diego Alejandro Cubides-Diaz |
| collection | DOAJ |
| description | Background: <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> primarily causes pneumonia in immunosuppressed individuals, particularly those living with advanced HIV/AIDS. Extrapulmonary dissemination is uncommon, with bone marrow involvement described in only a handful of cases globally. Bone marrow infection occurs in the setting of severe immunosuppression, poses diagnostic challenges, and carries a high mortality rate. Methods: We describe the case of a 34-year-old man newly diagnosed with HIV/AIDS, presenting with severe immunosuppression and <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> pneumonia. The patient initially improved with cotrimoxazole and corticosteroids, but was readmitted shortly after discharge with abdominal pain, diarrhea, and worsening pancytopenia. A bone marrow biopsy revealed <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> cysts, confirming disseminated infection. Concomitant Kaposi sarcoma involving the skin and gastrointestinal tract was also diagnosed. Despite antimicrobial therapy, the patient’s condition worsened, leading to multisystem organ failure and death two months later. Conclusions: This case highlights a rare presentation of disseminated <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> infection with bone marrow involvement in a patient with advanced HIV/AIDS. Although infrequent, this complication should be considered in individuals with <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> pneumonia who develop persistent cytopenias and systemic symptoms. Diagnosis depends on histopathologic confirmation, which may lead to under-recognition. Early suspicion and individualized management are essential, though the optimal treatment approach for extrapulmonary infection remains undefined. |
| format | Article |
| id | doaj-art-e83e16b01ca441ba97a256ae22f5e3a2 |
| institution | Kabale University |
| issn | 2036-7449 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Infectious Disease Reports |
| spelling | doaj-art-e83e16b01ca441ba97a256ae22f5e3a22025-08-20T03:24:38ZengMDPI AGInfectious Disease Reports2036-74492025-05-011734710.3390/idr17030047Bone Marrow Infection by <i>Pneumocystis jirovecii</i> in a Patient with AIDS: A Case Report and Literature ReviewDiego Alejandro Cubides-Diaz0Valentina Negrette-Lazaro1Viviana Poveda-Hurtado2Juan Pablo López-Salazar3Carlos Mauricio Calderón-Vargas4Carlos Arturo Álvarez-Moreno5Department of Internal Medicine, Universidad Nacional de Colombia, Bogotá 111321, ColombiaFaculty of Medicine, Universidad del Rosario, Bogotá 111221, ColombiaDepartment of Internal Medicine, Universidad de La Sabana, Chía 250001, ColombiaDepartment of Internal Medicine, Hospital Universitario de La Samaritana, Zipaquirá 250252, ColombiaDepartment of Internal Medicine, Hospital Universitario de La Samaritana, Bogotá 110411, ColombiaFaculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, ColombiaBackground: <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> primarily causes pneumonia in immunosuppressed individuals, particularly those living with advanced HIV/AIDS. Extrapulmonary dissemination is uncommon, with bone marrow involvement described in only a handful of cases globally. Bone marrow infection occurs in the setting of severe immunosuppression, poses diagnostic challenges, and carries a high mortality rate. Methods: We describe the case of a 34-year-old man newly diagnosed with HIV/AIDS, presenting with severe immunosuppression and <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> pneumonia. The patient initially improved with cotrimoxazole and corticosteroids, but was readmitted shortly after discharge with abdominal pain, diarrhea, and worsening pancytopenia. A bone marrow biopsy revealed <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> cysts, confirming disseminated infection. Concomitant Kaposi sarcoma involving the skin and gastrointestinal tract was also diagnosed. Despite antimicrobial therapy, the patient’s condition worsened, leading to multisystem organ failure and death two months later. Conclusions: This case highlights a rare presentation of disseminated <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> infection with bone marrow involvement in a patient with advanced HIV/AIDS. Although infrequent, this complication should be considered in individuals with <i data-eusoft-scrollable-element="1">Pneumocystis jirovecii</i> pneumonia who develop persistent cytopenias and systemic symptoms. Diagnosis depends on histopathologic confirmation, which may lead to under-recognition. Early suspicion and individualized management are essential, though the optimal treatment approach for extrapulmonary infection remains undefined.https://www.mdpi.com/2036-7449/17/3/47<i>Pneumocystis jirovecii</i>extrapulmonary infectionbone marrowAIDSopportunistic infectionscase report |
| spellingShingle | Diego Alejandro Cubides-Diaz Valentina Negrette-Lazaro Viviana Poveda-Hurtado Juan Pablo López-Salazar Carlos Mauricio Calderón-Vargas Carlos Arturo Álvarez-Moreno Bone Marrow Infection by <i>Pneumocystis jirovecii</i> in a Patient with AIDS: A Case Report and Literature Review Infectious Disease Reports <i>Pneumocystis jirovecii</i> extrapulmonary infection bone marrow AIDS opportunistic infections case report |
| title | Bone Marrow Infection by <i>Pneumocystis jirovecii</i> in a Patient with AIDS: A Case Report and Literature Review |
| title_full | Bone Marrow Infection by <i>Pneumocystis jirovecii</i> in a Patient with AIDS: A Case Report and Literature Review |
| title_fullStr | Bone Marrow Infection by <i>Pneumocystis jirovecii</i> in a Patient with AIDS: A Case Report and Literature Review |
| title_full_unstemmed | Bone Marrow Infection by <i>Pneumocystis jirovecii</i> in a Patient with AIDS: A Case Report and Literature Review |
| title_short | Bone Marrow Infection by <i>Pneumocystis jirovecii</i> in a Patient with AIDS: A Case Report and Literature Review |
| title_sort | bone marrow infection by i pneumocystis jirovecii i in a patient with aids a case report and literature review |
| topic | <i>Pneumocystis jirovecii</i> extrapulmonary infection bone marrow AIDS opportunistic infections case report |
| url | https://www.mdpi.com/2036-7449/17/3/47 |
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