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Pneumocystis jirovecii Pneumonia in Patients Receiving Tumor-Necrosis-Factor-Inhibitor Therapy: Implications for Chemoprophylaxis

  • Infections and Arthritis (K Winthrop, Section Editor)
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Abstract

Pneumocystis jirovecii pneumonia (PJP) is an important opportunistic infection that has been increasingly reported in patients with rheumatic disease. Reported incidence among patients taking TNF inhibitors (TNFi) has varied, but has usually been low. Still, disease causes significant mortality among those affected and must be considered in patients with rheumatological disease presenting with dyspnea and cough. Diagnosis can be difficult in the non-HIV population, and our understanding of the epidemiology and natural history after exposure is changing. Trimethoprim–sulfamethoxazole is believed to be the most effective agent for treatment and prophylaxis, but is associated with significant adverse effects. Given the low incidence reported in most studies of patients on TNFi, prophylaxis is probably not beneficial for this patient population as a whole.

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James A. Grubbs declares that he has no conflict of interest. John W. Baddley declares that he has served as a consultant for Pfizer, Astellas, and Merck, and that he has received a research grant from BMS.

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  1. Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, 1900 University Boulevard, 229 Tinsley Harrison Tower, Birmingham, AL, 35294-0006, USA

    James A. Grubbs & John W. Baddley

  2. Birmingham Veterans Affairs Medical Center, 700 19th Street South, Birmingham, Alabama, 35233, USA

    John W. Baddley

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Grubbs, J.A., Baddley, J.W. Pneumocystis jirovecii Pneumonia in Patients Receiving Tumor-Necrosis-Factor-Inhibitor Therapy: Implications for Chemoprophylaxis. Curr Rheumatol Rep 16, 445 (2014). https://doi.org/10.1007/s11926-014-0445-4

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