Wu WH, Hui TC, Wu QQ, Xu CA, Zhou ZW, Wang SH, Zheng W, Yin QQ, Li X, Pan HY. Pneumocystis jirovecii and Legionella pneumophila coinfection in a patient with diffuse large B-cell lymphoma: A case report. World J Clin Cases 2021; 9(28): 8595-8601 [PMID: 34754873 DOI: 10.12998/wjcc.v9.i28.8595]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wen-Hao Wu, Medical College, Qingdao University, Qingdao 266071, Shandong Province, China
Xi Li, Centre of Laboratory Medicine, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Author contributions: Li X and Pan HY designed the research study; Wu WH, Hui TC, and Wu QQ performed the research; Xu CA, Zhou ZW, and Wang SH contributed new reagents and analytic tools; Yin QQ analysed the data; and Wu WH wrote the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: The patient‘s husband signed an informed consent form. This study has been reviewed and approved by the Research Ethics Committee of Zhejiang Provincial People’s Hospital (ref#2021QT165).
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Received: May 25, 2021 Peer-review started: May 25, 2021 First decision: June 25, 2021 Revised: July 1, 2021 Accepted: August 10, 2021 Article in press: August 10, 2021 Published online: October 6, 2021
Diffuse large B-cell lymphoma (DLBCL) is a common non-Hodgkin's lymphoma. R-CHOP is a protocol for long-term chemotherapy for DLBCL patients. Long-term chemotherapy can lead to low immunity and increase the risk of opportunistic pathogen infections in immunocompromised patients.
We report a case of coinfection with Pneumocystis jirovecii (P. jirovecii) and Legionella pneumophila (L. pneumophila) in a patient with DLBCL. The patient was a 40-year-old female who was diagnosed with DLBCL and was admitted due to pulmonary infection. P. jirovecii and L. pneumophila were detected in her bronchoalveolar lavage fluid by hexamine silver staining, isothermal amplification and metagenomic sequencing.
To the best of our knowledge, this is the first case of P. jirovecii and L. pneumophila coinfection found in a DLBCL patient. Clinicians should be aware of the risk of complicated infection in patients undergoing long-term chemotherapy.
Core Tip: Coinfection of Pneumocystis and Legionella is very rare. This is the first case of such infection in a patient with diffuse large B cell lymphoma. This case is significate for the detection of pathogens and the diagnosis and treatment of related diseases.