Pneumocystis carinii Pneumonia during Cyclosporine Therapy for Ulcerative Colitis

To the Editor: Cyclosporine has been used in patients with severe refractory inflammatory bowel disease^{1 , 2} without an increase in infectious complications.³ We report a case of Pneumocystis carinii pneumonia that occurred in a man with ulcerative colitis during treatment with cyclosporine. Fever, bloody diarrhea, and abdominal cramps developed in a 32-year-old man receiving maintenance therapy with mesalamine. His symptoms persisted despite seven days of intravenous hydrocortisone therapy. The patient rejected recommendations that he undergo colectomy. He was therefore treated with 4 mg of intravenous cyclosporine per kilogram of body weight per day, and the intravenous hydrocortisone (300 mg per day)…