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Clinical, Laboratory, and Biomarker Predictors of 90-Day Mortality in Non-HIV, Non-Transplant Pneumocystis Pneumonia

Summary

This study examined pneumocystis pneumonia in immunocompromised patients who do not have HIV or transplants. Researchers found that older patients with other health conditions were at higher risk of death within 90 days. High levels of fungal markers and low immune cell counts were better predictors of poor outcomes than traditional inflammation markers, suggesting doctors should focus on early identification and personalized treatment approaches.

Background

Pneumocystis jirovecii pneumonia (PJP) poses a growing threat in immunocompromised, non-HIV, non-transplant adults. Clinical features and pathogenesis associated with mortality are poorly characterized in this population.

Objective

This study explores clinical features and biomarkers reflecting immunologic capacity, inflammation, and pathogen load associated with non-HIV, non-transplant PJP 90-day mortality.

Results

In 578 non-HIV, non-transplant PJP patients, 90-day mortality was 29.4%. Non-survivors were older, had higher Charlson comorbidity index, and increased prevalence of liver disease and heart failure. Non-survivors showed lower lymphocyte counts, hemoglobin, and platelets, with elevated total bilirubin. Higher serum β-D-glucan and ferritin were associated with mortality, while CRP and fibrinogen showed no significant differences.

Conclusion

In non-HIV, non-transplant adults with PJP, 90-day mortality was associated with older age and organ dysfunction. Immune dysfunction markers and fungal burden biomarkers predicted mortality, while inflammation indicators did not. Clinicians should prioritize early identification and management of high-risk patients.
  • Published in:Open Forum Infectious Diseases,
  • Study Type:Retrospective Cohort Study,
  • Source: 10.1093/ofid/ofaf695.2122, PMC12793478
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