Pneumocystis pneumonia following surgery for left-sided tongue cancer: A case study

Pneumocystis pneumonia (PCP) is an opportunistic infection in immunocompromised patients. Pneumocystis jirovecii has been frequently observed as a pathogen in patients infected with human immunodeficiency virus (HIV), but it has recently been reported to occur in HIV-negative patients as well. We present the case of a 70 year-old woman being treated with corticosteroid therapy for immunoglobulin A nephropathy. During her first visit to our department in August 2018, she was diagnosed with left-sided tongue cancer (T2N0M0 Stage II), and a resection was performed in September 2018. On the sixth postoperative day, a chest computed tomography scan showed a frosted shadow and a high beta-D glucan level (33.5 pg/mL) was noted, leading to the diagnosis of PCP. Treatment with a fixed-dose combination of sulfamethoxazole and trimethoprim was initiated on the eighth postoperative day, and the patient was discharged in October 2018. PCP is associated with a poor prognosis and high disease progression and mortality rates. Prevention is paramount to improving outcomes in patients undergoing oral surgery and those with a history of immunoglobulin A nephropathy undergoing steroid therapy.