Pneumocystis Pneumonia in Cirrhosis: An Underrecognized Fungal Infection in a Vulnerable Host
Pneumocystis pneumonia (PCP) is a serious fungal infection affecting immunocompromised hosts. Decompensated cirrhosis leads to cirrhosis-associated immune dysfunction (CAID), a form of impaired cellular immunity that may predispose patients to opportunistic infections such as PCP. We conducted a ret...
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| Príomhchruthaitheoirí: | , , , , , , , , , |
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| Formáid: | Alt |
| Teanga: | Béarla |
| Foilsithe / Cruthaithe: |
MDPI AG
2025-07-01
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| Sraith: | Journal of Fungi |
| Ábhair: | |
| Rochtain ar líne: | https://www.mdpi.com/2309-608X/11/7/500 |
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| Achoimre: | Pneumocystis pneumonia (PCP) is a serious fungal infection affecting immunocompromised hosts. Decompensated cirrhosis leads to cirrhosis-associated immune dysfunction (CAID), a form of impaired cellular immunity that may predispose patients to opportunistic infections such as PCP. We conducted a retrospective review of 727 patients with proven or probable PCP from 2017 to 2025. Of these, 33 had decompensated cirrhosis. These patients were stratified into two groups: Cirrhosis Only (n = 16) and Cirrhosis with Additional Immunocompromising Conditions (n = 17). Among the patients with cirrhosis, the overall mortality was 48%, with the 90-day mortality reaching 57.6% (95% CI: 39.2–74.5%). Compared with those without cirrhosis, the patients with cirrhosis had a higher risk of mortality (OR: 4.08, 95% CI: 2.01–8.30, <i>p</i> < 0.001), increased intensive care unit (ICU) admission (87% vs. 42%, <i>p</i> < 0.001), and greater need for renal replacement therapy (54.6% vs. 7.5%, <i>p</i> < 0.001). These findings suggest that decompensated cirrhosis alone may represent a sufficient and underrecognized risk factor for PCP, with a high associated mortality. Given the preventable nature of this infection, future studies are needed to assess the incidence, define the risk, and investigate the role of prophylaxis in this vulnerable population. |
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| ISSN: | 2309-608X |