Abstract：
Late-onset Pneumocystis jirovecii pneumonia (PCP) can be developed in solid organ transplant (SOT) patients. Granulomatous P. jirovecii pneumonia (GPCP) can occur in immunocompromised patients, but has rarely been reported in SOT recipients. The diagnosis of GPCP is difficult since the sensitivity of sputum and bronchoalveolar lavage is low and atypical patterns are shown. A 60-year-old man, who had undergone renal transplantation 24 years ago presented with nodular and patchy lung lesions. He was asymptomatic and stable. After empirical treatment with a fluoroquinolone, the condition partially resolved but relapsed 4 months later. The pulmonary nodule was resected, and GPCP was confirmed. The pathogenesis of GPCP remains unclear, but in SOT recipients presenting with an atypical lung pattern, GPCP should be considered. This case was discussed at the Grand Clinical Ground of the Korean Society of Infectious Disease conference on November 3, 2022.
摘要：
晚期肺孢子虫肺炎（PCP）可在实体器官移植（SOT）患者中发展。肉芽肿性P.jirovecii肺炎（GPCP）可发生在免疫功能低下的患者，但很少在SOT接受者中报道。GPCP的诊断很困难，因为痰和支气管肺泡灌洗的敏感性很低，并且显示出非典型的模式。一个60岁的老人,24年前接受肾移植的患者出现结节状和斑片状肺部病变。他无症状且病情稳定。在用氟喹诺酮进行经验性治疗后，病情部分缓解,但4个月后复发.切除了肺结节,GPCP得到证实。GPCP的发病机制尚不清楚,但是在表现为非典型肺部模式的SOT接受者中，应考虑GPCP。该病例在2022年11月3日的韩国传染病学会大临床会议上进行了讨论。
