Kageyama et al identifiedprognostic factors for patients with systemic autoimmune diseases who developed Pneumocystis infections. These can help to identify a patient who may require more aggressive management. The authors are from Chiba University, Asahi General Hospital, Shimoshizu Hospital, Matsudo City General Hospital and SaiseikaiNarashino Hospital in Chiba, Japan.
Patient selection: Pneumocystis pneumonia in a patient with a systemic autoimmune disease
Prognostic factors impacting mortality from multivariate analysis:
(1) lower absolute lymphocyte count (< 500 per µL, OR 29.92)
(2) age >= 65 years (OR 8.68)
(3) co-existing lung disease (OR 4.35)
Additional factors:
(1) higher daily doses of prednisolone in mg, especially when >= 10 mg per day
A patient identified as being at risk may benefit from prophylactic anti-PCP therapy.
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