PT  - JOURNAL ARTICLE
AU  - Nathaniel Lee
AU  - David Lawrence
AU  - Brijesh Patel
AU  - Stephane Ledot
TI  - HIV-related <em>Pneumocystis jirovecii</em> pneumonia managed with caspofungin and veno-venous extracorporeal membrane oxygenation rescue therapy
AID  - 10.1136/bcr-2017-221214
DP  - 2017 Oct 04
TA  - BMJ Case Reports
PG  - bcr-2017-221214
VI  - 2017
4099  - http://casereports.bmj.com/content/2017/bcr-2017-221214.short
4100  - http://casereports.bmj.com/content/2017/bcr-2017-221214.full
AB  - Patients with pneumocystis pneumonia have a risk of progressing to acute respiratory failure necessitating admission to intensive care. The case described is of a patient with a newly diagnosed HIV infection presenting with pneumocystis pneumonia. Despite initiating the appropriate pharmacological treatment the patient’s clinical condition deteriorated, and required both rescue pharmacological therapy with echinocandins as well as respiratory support with extracorporeal membrane oxygenation therapy. The patient recovered well on ventilator and circulatory support despite a long weaning process complicated by sequelae common to pneumocystis pneumonia. Following initialisation of antiretroviral therapy and step-down from an intensive care setting, the patient required further prolonged hospital stay for rehabilitation and mental health support before being discharged. This case reviews the novel pharmacological therapies and respiratory support strategies used in cases of pneumocystis pneumonia, including the clinical and psychological sequelae that may follow.