{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T01:08:17Z","timestamp":1780708097789,"version":"3.54.1"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"Supplement_5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4,1]]},"abstract":"<jats:p>Sirolimus is an effective therapy for children with kaposiform hemangioendothelioma with or without the Kasabach-Merritt phenomenon. We report the case of a child with kaposiform hemangioendothelioma and the Kasabach-Merritt phenomenon who developed Pneumocystis carinii pneumonia (PCP) while on sirolimus and a prednisolone taper, after lack of adequate response to prednisolone, propranolol, and vincristine. He had a prompt positive clinical and laboratory response to sirolimus, but 4 weeks after starting it, at the age of 4 months, he developed PCP. This led to respiratory failure, which required extracorporeal membrane oxygenation. Sirolimus was temporarily discontinued, and he was successfully treated for PCP with sulfamethoxazole-trimethoprim and methylprednisolone. He was restarted on sirolimus 3 weeks after discharge and given sulfamethoxazole-trimethoprim prophylaxis. At the age of 22 months, while still on sirolimus, the lesion continued to improve with test results revealing stable hemoglobin and platelet counts. PCP is a rare but life-threatening side effect of sirolimus therapy, especially in the setting of concurrent steroid treatment. Pneumocystis prophylaxis should be considered for patients receiving sirolimus.<\/jats:p>","DOI":"10.1542\/peds.2017-1044","type":"journal-article","created":{"date-parts":[[2018,4,2]],"date-time":"2018-04-02T08:35:25Z","timestamp":1522658125000},"page":"S421-S424","source":"Crossref","is-referenced-by-count":55,"title":["<i>Pneumocystis Jirovecii<\/i> Pneumonia During Sirolimus Therapy for Kaposiform Hemangioendothelioma"],"prefix":"10.1542","volume":"141","author":[{"given":"Thomas B.","family":"Russell","sequence":"first","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily K.","family":"Rinker","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire S.","family":"Dillingham","sequence":"additional","affiliation":[{"name":"Plastic Surgery, Wake Forest School of Medicine, Winston-Salem, 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