Coinfection of Pneumocystis jirovecii and Aspergillus fumigatus in the lung: A case report.

Authors

Ming-Hong He, Xiang-Lei Chen, Bao-Tong Feng

Published in

Medicine. Volume 105. Issue 38. Pages e50705. Sep 18, 2026.

Abstract

Coinfection with Pneumocystis jirovecii and Aspergillus fumigatus in immunocompromised patients carries high mortality. More importantly, paradoxical clinical and radiological responses during treatment remain poorly understood.
A 66-year-old male with mantle cell lymphoma who had received prolonged corticosteroid therapy after suspected rituximab-associated lung injury presented with progressive pulmonary symptoms.
Concurrent pulmonary infection with P jirovecii and A fumigatus was confirmed by bronchoalveolar lavage combined with metagenomic next-generation sequencing.
The patient was treated with trimethoprim-sulfamethoxazole and voriconazole.
Clinical symptoms improved markedly; however, chest imaging showed paradoxical progression, possibly reflecting an immune reconstitution inflammatory syndrome-like inflammatory response.
bronchoalveolar lavage combined with metagenomic next-generation sequencing enables rapid diagnosis of concurrent opportunistic pulmonary infections. Paradoxical radiographic worsening despite clinical improvement may suggest an immune reconstitution inflammatory syndrome-like inflammatory response, although persistent or progressive infection cannot be excluded.

PMID:
42760695
Bibliographic data and abstract were imported from PubMed on 19 Sep 2026.

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