Only a few cases of pneumocystis pneumonia (PCP) in Cushing's syndrome have been published in the literature so far. In the majority of these patients, the pneumonia occurred after reduction of the hypercortisolism with medicamentous treatment. We report two cases of PCP during conservative treatment of hypercortisolism. We describe clinical, imaging and laboratory findings in two patients and review published cases of pneumocystits pneumonia in Cushing's syndrome. A 60-year-old woman and 20-year-old man with Cushing's syndrome due to ectopic ACTH syndrome were treated at our department. Both developed pneumocystis pneumonia early after treatment with ketoconazole and ethomidate bromide had been introduced and the levels of cortisol rapidly decreased. PCP prophylaxis in patients with high cortisolemia should be started before treatment of hypercortisolism in current practice. Gradual lowering of plasma cortisol should also reduce the risk of infection by Pneumocystis jiroveci.

Charles University Prague Faculty of Medicine and University Hospital 2nd Department of Internal Medicine Hradec Králové

Charles University Prague Faculty of Medicine and University Hospital Department of Surgery Hradec Králové

Obsahuje 1 tabulku

Literatura

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$a Gabalec, Filip $7 xx0108078 $u Charles University in Prague, Faculty of Medicine and University Hospital, Second Department of Internal Medicine, Hradec Králové

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$a Pneumocystis pneumonia during medicamentous treatment of Cushing's syndrome – a description of two cases / $c Filip Gabalec, Alžběta Zavřelová, Eduard Havel, Jaroslav Cerman, jr., Jakub Radocha, Ioannis Svilias, Jan Čáp

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$a Only a few cases of pneumocystis pneumonia (PCP) in Cushing's syndrome have been published in the literature so far. In the majority of these patients, the pneumonia occurred after reduction of the hypercortisolism with medicamentous treatment. We report two cases of PCP during conservative treatment of hypercortisolism. We describe clinical, imaging and laboratory findings in two patients and review published cases of pneumocystits pneumonia in Cushing's syndrome. A 60-year-old woman and 20-year-old man with Cushing's syndrome due to ectopic ACTH syndrome were treated at our department. Both developed pneumocystis pneumonia early after treatment with ketoconazole and ethomidate bromide had been introduced and the levels of cortisol rapidly decreased. PCP prophylaxis in patients with high cortisolemia should be started before treatment of hypercortisolism in current practice. Gradual lowering of plasma cortisol should also reduce the risk of infection by Pneumocystis jiroveci.

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$a Havel, Eduard, $d 1962- $7 xx0065539 $u Charles University in Prague, Faculty of Medicine and University Hospital, Department of Surgery, Hradec Králové

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$a Cerman, Jaroslav $7 xx0127748 $u Charles University in Prague, Faculty of Medicine and University Hospital, Department of Surgery, Hradec Králové

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$a Radocha, Jakub, $d 1981- $7 xx0233189 $u Charles University in Prague, Faculty of Medicine and University Hospital, Second Department of Internal Medicine, Hradec Králové

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$a Svilias, Ioannis. $7 _AN065212 $u Charles University in Prague, Faculty of Medicine and University Hospital, Second Department of Internal Medicine, Hradec Králové

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$a Čáp, Jan, $d 1953- $7 mzk2003190513 $u Charles University in Prague, Faculty of Medicine and University Hospital, Second Department of Internal Medicine, Hradec Králové

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