{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T14:06:44Z","timestamp":1770473204153,"version":"3.49.0"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"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. Pediatr."],"abstract":"\n Objective<\/jats:title>\n To retrospectively analyze the clinical characteristics, treatment, and prognosis of five pediatric patients with nephrotic syndrome who developed Pneumocystis carinii pneumonia (PJP) after long-term use of steroids and tacrolimus.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A review was conducted on five cases of nephrotic syndrome in children who developed Pneumocystis pneumonia after long-term treatment with steroids and tacrolimus. The initial symptoms, early clinical characteristics, and imaging changes were summarized. Among these cases, two were diagnosed through alveolar lavage fluid metagenomic testing and three through sputum metagenomic testing (BGI Genomics Co.), all indicating (pneumocystis carinii pneumonia. All five patients received early treatment with sulfa drugs, with three of them also receiving caspofungin.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n One child died and four were discharged with symptomatic improvement.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n PJP is a severe opportunistic infection that can progress rapidly and lead to life-threatening respiratory failure, particularly in immunocompromised individuals. Among children with nephrotic syndrome (NS), prolonged exposure to glucocorticoids, tacrolimus, or other immunosuppressive agents markedly increases susceptibility to PJP. Therefore, heightened clinical vigilance, early etiological diagnosis, and prompt initiation of appropriate therapy are essential to improving clinical outcomes in this population.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fped.2025.1687471","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:29:18Z","timestamp":1765175358000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Pneumocystis jiroveci pneumonia: report of five children with the nephrotic syndrome and review of the literature"],"prefix":"10.3389","volume":"13","author":[{"given":"Peitong","family":"Han","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoying","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunzhen","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jieyuan","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S0140-6736(03)14184-0","article-title":"Nephrotic syndrome in childhood","volume":"362","author":"Eddy","year":"2003","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"4631297","DOI":"10.1155\/2020\/4631297","article-title":"Pneumocystis jirovecii pneumonia in patients with nephrotic syndrome: application of lymphocyte subset analysis in predicting clinical outcomes","volume":"2020","author":"Liu","year":"2020","journal-title":"Can J Infect Dis Med Microbiol J Can Mal Infect Microbiol Medicale"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1080\/14656566.2021.1915989","article-title":"Pneumocystis jirovecii: a review with a focus on prevention and treatment","volume":"22","author":"Weyant","year":"2021","journal-title":"Expert Opin Pharmacother"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1080\/17476348.2022.2152332","article-title":"A comprehensive clinical guide for pneumocystis jirovecii pneumonia: a missing therapeutic target in HIV-uninfected patients","volume":"16","author":"Alsayed","year":"2022","journal-title":"Expert Rev Respir Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1007\/s00134-024-07489-2","article-title":"Pneumocystis pneumonia in intensive care: clinical spectrum, prophylaxis patterns, antibiotic treatment delay impact, and role of corticosteroids. A French multicentre prospective cohort study","volume":"50","author":"Kamel","year":"2024","journal-title":"Intensive Care Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"755","DOI":"10.2147\/IDR.S398850","article-title":"Development and validation of a diagnostic nomogram for pneumocystis jirovecii pneumonia in non-HIV-infected pneumonia patients undergoing oral glucocorticoid treatment","volume":"16","author":"Lang","year":"2023","journal-title":"Infect Drug Resist"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1067634","DOI":"10.3389\/fped.2022.1067634","article-title":"Case report: successful treatment of severe pneumocystis carinii pneumonia in a case series of primary nephrotic syndrome after receiving anti-CD20 monoclonal antibody therapy","volume":"10","author":"Liu","year":"2023","journal-title":"Front Pediatr"},{"key":"B8","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1007\/s00467-012-2286-6","article-title":"Atypical pneumocystis jiroveci pneumonia with multiple nodular granulomas after rituximab for refractory nephrotic syndrome","volume":"28","author":"Sato","year":"2013","journal-title":"Pediatr Nephrol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"226","DOI":"10.5414\/CN110679","article-title":"Pneumocystis pneumonia in patients with primary nephrotic syndrome","volume":"97","author":"Zhou","year":"2022","journal-title":"Clin Nephrol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2450","DOI":"10.1001\/jama.286.19.2450","article-title":"New insights into transmission, diagnosis, and drug treatment of pneumocystis carinii pneumonia","volume":"286","author":"Kovacs","year":"2001","journal-title":"JAMA"},{"key":"B11","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1007\/s00467-013-2457-0","article-title":"Difficulties in diagnosing severe pneumocystis jiroveci pneumonia after rituximab therapy for steroid-dependent nephrotic syndrome","volume":"28","author":"Czarniak","year":"2013","journal-title":"Pediatr Nephrol Berl Ger"},{"key":"B12","doi-asserted-by":"publisher","first-page":"99","DOI":"10.5414\/cnp68099","article-title":"Remission of nephrotic membranous glomerulonephritis after high-dose trimethoprim-sulfamethoxazole treatment for pneumocystis jiroveci pneumonia","volume":"68","author":"Wen","year":"2007","journal-title":"Clin Nephrol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1687471\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T06:29:19Z","timestamp":1765175359000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1687471\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":12,"alternative-id":["10.3389\/fped.2025.1687471"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1687471","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,8]]},"article-number":"1687471"}}