Combined Trimethoprim and Caspofungin Treatment for Severe Pneumocystis Jiroveci Pneumonia in a Five Year Old Boy with Acute Lymphoblastic Leukemia

Abstract

Caspofungin was used for the first time with trimethoprim/sulfamethoxazole (TMP/SMX) for treatment of high risk Pneumocystis jiroveci pneumonia (PCP) in a pediatric immunocompromised patient. Despite the need for mechanical ventilation, the pediatric patient with relapsed acute lymphoblastic leukemia improved within nine days of treatment and showed no major side effects. The apparent relative lack of toxicity and of pharmacokinetic drug interactions makes caspofungin an attractive agent.

Zusammenfassung

Caspofungin wurde zum ersten Mal in Kombination mit Trimethoprim/Sulfamethoxazol (TMP/SMX) für die Behandlung einer Pneumocystis-jiroveci-Pneumonie (PCP) bei einem pädiatrischen immunsupprimierten Patienten eingesetzt. Trotz Beatmungspflichtigkeit kam es bei dem Patienten mit dem Rezidiv einer akuten lymphatischen Leukämie nach neuntägiger Behandlung zu einer deutlichen Besserung der klinischen Situation ohne größere Nebenwirkungen. Die gute Verträglichkeit und das Fehlen von pharmakokinetischen Interaktionen machen Caspofungin zu einem attraktiven Wirkstoff.

Key words

pneumocystis jiroveci pneumonia - acute respiratory failure - immunosuppression

Schlüsselwörter

Pneumocystis-jiroveci-Pneumonie - akute Ateminsuffizienz - Immunsuppression

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