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Pneumocystis jiroveci and cytomegalovirus co-infection in an immunocompromised patient
Abstract
Pneumocystis jiroveci pneumonia (PCP) and cytomegalovirus (CMV) are opportunistic infection seen in patients with advanced immunocompromised states, such as HIV infection. We present a case of PCP-CMV co-infection in a patient with newly diagnosed HIV disease. The presence of CMV in the context of another opportunistic respiratory tract infection is often presumed non-invasive and not treated. Our report highlights that this is not always the case. Invasive CMV disease can be easily misdiagnosed and remains a potentially fatal affliction. We postulate that the use of high-dose corticosteroids used as an adjunct in the treatment of serious PCP can lead to the reactivation of CMV infection and clinical disease. Moreover, we suggest that there may be a role for serial viral load measurement, analogous to protocols often utilised in solid-organ transplant patients receiving immunosuppression.