Pneumocystis pneumonia suspected cases in 604 non-HIV and HIV patients

•We retrospectively reviewed HIV and non-HIV Pneumocystosis patients diagnosed in our department during a nine year period.•A total of 21274 bronchoalveolar samples were received, leading to a discharge diagnosis of Pneumocystosis for 604 patients (143 HIV-positive and 461 HIV-negative).•The ratio of non-HIV versus HIV patients presenting with PCP increased from 1.7 to 5.6 during the study period.•The mortality rate at day 14 was 16%, occurring mostly in non-HIV patients (20.6% compared to 1.4%, P < 0.0001).•Real-time PCR is a useful tool for the diagnosis of Pneumocystosis in non-HIV patients.•This study highlights the need for international guidelines for prophylaxis of Pneumocystosis in non-HIV patients.

BackgroundPneumocystis pneumonia (PCP) is one of the most devastating fungal diseases in patients with impaired immunity. Effective antiviral therapies have reduced the burden of PCP among AIDS patients, but an increase in the prevalence of this disease among persons receiving immunosuppressive therapies has been reported.MethodsWe retrospectively reviewed HIV and non-HIV PCP patients diagnosed in our department during a nine year period. Data were collected from the local database completed during the diagnosis procedure. For each patient, demographic, clinical, radiological, biological and therapeutic data were analyzed.ResultsA total of 21,274 bronchoalveolar samples were received from patients suspected of pneumocystosis during the study period, leading to a discharge diagnosis of PCP for 604 patients (143 HIV-positive and 461 HIV-negative). The ratio of non-HIV versus HIV patients presenting PCP increased from 1.7 to 5.6 during the study period. The mortality rate at day 14 was 16%, occurring mostly in non-HIV patients (20.6% compared to 1.4%, P < 0.0001), while non-HIV patients were less symptomatic at diagnosis than AIDS patients.ConclusionsThis study presents one of the higher number of HIV and non-HIV patients presenting with PCP in a single center. Pneumocystosis is now a crucial health challenge for patients receiving immunosuppressive therapy, with a high mortality rate. This study highlights the need for international guidelines for prophylaxis of PCP in non-HIV patients.