{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:59:42Z","timestamp":1791849582762,"version":"4.3.4"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T00:00:00Z","timestamp":1645574400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Combined variable immunodeficiency (CVID) is a primary immunodeficiency, characterized by impairment in immune system function. These patients are susceptible to opportunistic infections, which may mimic COVID-19 manifestations. Also, misdiagnosis or delayed diagnosis of opportunistic infections can lead to perilous consequences. We report a 28-year-old woman with a history of combined variable immunodeficiency disorder (CVID) and ulcerative colitis (UC) complained of fever, cough, and dyspnea. According to the clinical and radiological manifestations and the COVID-19 epidemic, she was admitted with a primary diagnosis of COVID-19 pneumonia. After a week, the patient did not respond to treatment, so she underwent bronchoscopy. Using polymerase chain reaction (PCR) methodology, we detected DNA of <jats:italic>Pneumocystis jirovecii<\/jats:italic>, the causative agent of a life-threatening pneumonia (PCP), in respiratory specimens. The patient was hypersensitive to common PCP treatments, so she was treated with high-dose clindamycin. However, the patient's clinical condition aggravated. Besides, we found evidence of pneumothorax, pneumomediastinum, and pneumopericardium in chest CT scan. We inserted a catheter for the patient to evacuate the air inside the mediastinum. Also, we added caspofungin to the treatment. The patient eventually recovered and was discharged from the hospital about a week later. Thus, during the COVID-19 epidemic, in febrile patients with respiratory symptoms, physicians should not think only of COVID-19. They must consider opportunistic infections such as PCP, especially in immunocompromised patients.<\/jats:p>","DOI":"10.3389\/fmed.2022.814300","type":"journal-article","created":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T12:27:38Z","timestamp":1645619258000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Case Report: Pneumonia in a Patient With Combined Variable Immunodeficiency: COVID-19 or Pneumocystis Pneumonia?"],"prefix":"10.3389","volume":"9","author":[{"given":"Shabnam","family":"Tehrani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadi","family":"Ziaie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Kashefizadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahta","family":"Fadaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanieh","family":"Najafiarab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirreza","family":"Keyvanfar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1002\/iid3.450","article-title":"COVID-19 infection in CVID patients: What we know so far","volume":"9","author":"Weifenbach","year":"2021","journal-title":"Immun Inflamm Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"3575","DOI":"10.1016\/j.jaip.2021.06.019","article-title":"Common variable immunodeficiency disorders, T-cell responses to SARS-CoV-2 vaccines, and the risk of chronic COVID-19","volume":"9","author":"Ameratunga","year":"2021","journal-title":"J Allergy Clin Immunol Pract."},{"key":"B3","doi-asserted-by":"publisher","first-page":"3505","DOI":"10.3389\/fimmu.2020.614086","article-title":"Minor clinical impact of COVID-19 Pandemic on patients with primary immunodeficiency in Israel","volume":"11","author":"Marcus","year":"2021","journal-title":"Front Immunol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1089\/jir.2020.0210","article-title":"Role of host immune and inflammatory responses in COVID-19 cases with underlying primary immunodeficiency: a review","volume":"40","author":"Liu","year":"2020","journal-title":"J Interferon Cytokine Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1136\/postgradmedj-2020-137979","article-title":"COVID-19: to be or not to be; 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