Co-infection with invasive pulmonary aspergillosis and Pneumocystis jirovecii pneumonia after corticosteroid therapy

Hideharu Hagiya, Takayoshi Miyake, Yusuke Kokumai, Tomoko Murase, Yasutoshi Kuroe, Hiroyoshi Nojima, Junichi Sugiyama, Hiromichi Naito, Shingo Hagioka, Naoki Morimoto

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


A 95-year-old man with chronic obstructive pulmonary disease and chronic hepatitis C virus infection was treated for acute lung injury caused by Chlamydophila pneumoniae with antibiotics and high-dose corticosteroids. In total, 7,500 mg methylprednisolone and 680 mg prednisolone were administered over 21 days. However, respiratory failure progressed, and chest computed tomography (CT) scan showed bilateral ground-glass opacity and cavity-forming consolidation in the right upper lobe. Despite intensive therapy, the patient died of multiple organ failure on day 7. CT-guided necropsy was performed, and pathological examination revealed invasive pulmonary aspergillosis and Pneumocystis jirovecii pneumonia. Invasive pulmonary aspergillosis and P. jirovecii pneumonia are both life-threatening opportunistic fungal infections. Co-infection of these organisms is rare but possible if the patient is in an extremely immunocompromised state. Short-term but high-dose systemic corticosteroid therapy was considered to be the risk factor in this case. We should pay more attention to immunocompromised hosts who might be suffering from co-infection of opportunistic infections. Moreover, we need to consider preventive measures in such high-risk cases.

Original languageEnglish
Pages (from-to)342-347
Number of pages6
JournalJournal of Infection and Chemotherapy
Issue number2
Publication statusPublished - Apr 2013
Externally publishedYes


  • Coinfection
  • Corticosteroid therapy
  • Invasive pulmonary aspergillosis
  • Opportunistic infection
  • Pneumocystis jirovecii pneumonia

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases


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