[PAGID] Pneumocystis in HIGM

[Dewton]

Dear Lisa

Some time ago we had a similar problem with a primary CD4 
lymphocytopenia patient with relapsing pneumocystosis who presented 
associated hemolytic anemia due to sulphonamides and didn´t respond to 
pentamidine.
We treated him with clindamycin and primaquine with an adequate clinical 
response.

All the best

Dewton Vasconcelos, MD, PhD
University of Sao Paulo Medical School

Lisa Kobrynski, MD, MPH escreveu:


>I was wondering if anyone had experienced problems with failure of bactrim

>prophylaxis in patients with hyperIgM.

>

>One of our hyperIgM patients has had multiple episodes of pneumocystis pneumonia

>despite reported compliance with daily bactrim for prophylaxis.  Pneumocystis

>was isolated on BAL on at least one occasion and all episodes have been typical

>for pneumocystis pneumonitis and resolved with high dose bactrim and steroids. 

>He has been tried on Atovoquone and failed this medication as well, and could

>not tolerate IV Pentamidine.

>

>Has anyone seen failure of prophylaxis with Bactrim?  

>What other prophylactic/therapeutic agents would you recommend?

>

>Thanks

>

>Lisa Kobrynski, MD, MPH

>Assistant Professor of Pediatrics

>Division of Allergy and Immunology

>Emory University

>404-727-3575

>404-727-5045 (fax)

>

>

>  

>


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