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RMU

Uruguayan Medical Journal

ISSN: 1688-0390


Vol.31 - Nº 3 - Set. 2015

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Pneumocystis jiroveccii as a cause of fever of unknown origin in a patient with dermatomyositis and pulmonary thromboembolism

MENDEZ G; ANDRADE R; LOPEZ M; LLAMBI L
Rev Med Urug 2015; 31: 214-220
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract

Abstract

Dermatomyositis (DM), the same as other auto-immune diseases, has been reported in several studies as a risk factor for a venous thromboembolic disease. Also, given immunity alterations caused by the disease itself, along with the immunodepression that characterizes treatment, these patients are likely to present infectious complications, many of them due to opportunistic germs such as Pneumocystis jirovecci (PJ).

Diagnostic criteria for fever of unknown origin (FUO) have been long discussed. Lately, new categories that are different to the classic FUO have been proposed, as is the one affecting immunodepressed patients, where both the etiology and presentation vary. Over 200 causes for FUO have been described, PJ being among them.

The clinical case of a female patient diagnosed with DM is described in the study, who, in spite of thromboprofilaxis presented a pulmonary thromboembolism episode. Likewise, during hospitalization, the patient evidenced FUO. After an extensive search, PJ was isolated and treatment was applied, resulting in an excellent clinical response.