Atypical Pneumocystis carinii pneumonia in a child with hyper-IgM syndrome

Michael L Miller*, Ilham A. Algayed, Ram Yogev, Pauline M Chou, Paul R. Scholl, Lauren M Pachman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Children with hyper-immunoglobulin M (hyper-IgM) syndrome are at increased risk for Pneumocystis carinii pneumonia (PCP), an opportunistic infection often found in immunodeficient hosts. PCP can present with increasing hypoxia, fever, cough, and respiratory distress. We describe a child with hyper-IgM syndrome in whom bronchoalveolar washings were negative for PCP. However, there was an atypical lung response in which caseating granulomas predominated. The histopathology, resembling that found in tuberculosis, stresses the importance of a high index of clinical suspicion and histologic confirmation for early intervention and treatment. Immunocompromised children with rapidly progressive pulmonary disease may require lung biopsy and stains such as GMS to identify PCP.

Original languageEnglish (US)
Pages (from-to)71-78
Number of pages8
JournalPediatric Pathology and Laboratory Medicine
Volume18
Issue number1
DOIs
StatePublished - Apr 27 1998

Keywords

  • Granuloma
  • Hyper-IgM syndrome
  • Immunodeficiency diseases
  • Pneumocystis carinii pneumonia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pathology and Forensic Medicine

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