Reports and documents review of a cases of acute on chronic liver failure complicated with pneumocystis carinii pneumonia

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Objective To investigate the clinical features, imaging manifestations, diagnosis and treatment of a patient with acute on chronic liver failure (ACLF) complicated with pneumocystis carinii pneumonia (PCP). Methods The clinical data of an ACLF patient complicated with PCP were analyzed and related literature were reviewed. Results This patient developed fever, cough, chest tightness and dyspnea, and increased proportion of neutrophils and severe hypoxemia occurred after 2 months continuous treatment with oral immunosuppressive agents. Chest CT showed diffused exudative lesions of two lungs with glass-like changes, and pneumocystis carinii was found in bronchoalveolar lavage fluid smears. After treated with SMZ Co, methylprednisolone and other supportive therapy, and adjusted immunosuppressant regimen, the patient was discharged 26 days later. Conclusion PCP is a common opportunistic infection during immunosuppressive therapy for patients with ACLF; satisfactory results could be obtained by timely diagnosis and treatment. Key words: Acute on chronic liver failure; Pneumocystis carinii pneumonia (PCP); Diagnosis; Treatment

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