{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:10:06Z","timestamp":1756278606771,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2015,8,12]]},"abstract":"<jats:p>\n                  <jats:italic>Pneumocystis jirovecii<\/jats:italic> is responsible for <jats:italic>P. jirovecii<\/jats:italic> pneumonia (PJP) in immunocompromised individuals, with a recent rise of cases noted in non-HIV patients. A middle-aged man presented with new-onset cough, fever, hypoxia and tachypnoea. He was on a tapering course of dexamethasone for amiodarone-induced thyrotoxicosis. He developed worsening airspace disease necessitating mechanical ventilation. Bronchoalveolar lavage (BAL) fluid was positive for <jats:italic>P. jirovecii<\/jats:italic> and he was managed with trimethoprim\/sulfamethoxazole and pentamidine, but succumbed to cardiorespiratory arrest. One-third of PJP cases occur in non-HIV patients, and have a higher morbidity and mortality. Most immunocompromised patients typically exhibit PJP during a corticosteroid taper. The accurate dose, duration or frequency of steroid use in not well established. Diagnosis of PJP in this population is more challenging due to lower BAL yield with alternate modalities such as serum\/BAL \u03b2-<jats:sc>d<\/jats:sc>-glucan and PCR enhancing the yield. Further studies are needed to highlight PJP prophylaxis in patients with steroid use.<\/jats:p>","DOI":"10.1136\/bcr-2015-210117","type":"journal-article","created":{"date-parts":[[2015,8,26]],"date-time":"2015-08-26T09:57:38Z","timestamp":1440583058000},"page":"bcr2015210117","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Fatal <i>Pneumocystis jirovecii<\/i> pneumonia in a HIV-negative adult"],"prefix":"10.1136","volume":"2015","author":[{"given":"Toufik","family":"Mahfood Haddad","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saraschandra","family":"Vallabhajosyula","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Internal Medicine, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota, 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