{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:39:24Z","timestamp":1792269564118,"version":"4.4.0"},"reference-count":6,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,22]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                    pneumonia (PJP) is an increasingly recognised opportunistic infection among non-HIV immunocompromised patients receiving prolonged corticosteroid and immunosuppressive therapy who may present with progressive dyspnoea and fever and are initially treated for community-acquired pneumonia. Rapid clinical deterioration led to respiratory failure requiring invasive mechanical ventilation. Imaging revealed diffuse ground-glass opacities with bilateral pneumothoraces. Microbiological testing of sputum confirmed PJP. Despite targeted antimicrobial therapy and pleural drainage, the clinical course was complicated by persistent air leak, ventilator-associated pneumonia and refractory hypoxaemia, resulting in death. This case highlights the importance of early suspicion for PJP in non-HIV immunosuppressed patients and underscores bilateral pneumothorax as a rare but life-threatening complication. Consideration of prophylaxis and prompt evaluation for structural complications are essential to improve outcomes in high-risk populations.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2026-273572","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:15:21Z","timestamp":1790100921000},"page":"e273572","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["<i>Pneumocystis jirovecii<\/i>\n                    pneumonia in a non-HIV immunocompromised patient presenting with bilateral pneumothoraces"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5296-1493","authenticated-orcid":false,"given":"Neil Alden Yee","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Pulmonary Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel Marquez","family":"Santiaguel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"2026092211151388000_19.9.e273572.1","doi-asserted-by":"crossref","first-page":"3055","DOI":"10.2147\/IJGM.S349786","article-title":"Nomograms for Death from Pneumocystis jirovecii Pneumonia in HIV-Uninfected and HIV-Infected Patients","volume":"15","author":"Feng","year":"2022","journal-title":"Int J Gen Med"},{"key":"2026092211151388000_19.9.e273572.2","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/j.rmr.2015.06.007","article-title":"Pneumocystosis in HIV-negative adults","volume":"32","author":"Rouyer","year":"2015","journal-title":"Rev Mal Respir"},{"key":"2026092211151388000_19.9.e273572.3","doi-asserted-by":"crossref","first-page":"102712","DOI":"10.1016\/j.autrev.2020.102712","article-title":"Update in immunosuppressive therapy of myasthenia gravis","volume":"20","author":"Lascano","year":"2021","journal-title":"Autoimmun Rev"},{"key":"2026092211151388000_19.9.e273572.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12890-021-01812-z","article-title":"Clinical impact of pneumothorax in patients with Pneumocystis jirovecii pneumonia and respiratory failure in an HIV-negative cohort","volume":"22","author":"Choi","year":"2022","journal-title":"BMC Pulm Med"},{"key":"2026092211151388000_19.9.e273572.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-019-3723-y","article-title":"Pneumocystis jirovecii-related spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema in a liver transplant recipient: a case report","volume":"19","author":"She","year":"2019","journal-title":"BMC Infect Dis"},{"key":"2026092211151388000_19.9.e273572.6","article-title":"Pneumocystis jirovecii Pneumonia in Patients With Metastatic Prostate Cancer on Corticosteroids for Malignant Spinal Cord Compression: Two Case Reports and a Guideline Review","volume":"34","author":"Duarte","year":"2020","journal-title":"Oncology (Williston Park)"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-273572","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:15:22Z","timestamp":1790100922000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-273572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":6,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,22]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2026-273572"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-273572","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}