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A Potential Association

Timothy R. Franson, MD; H. Myron Kauffman, Jr, MD; Mark B. Adams, MD; Jacob Lemann, Jr, MD; Edwin Cabrera, MD; Linda Hanacik, RN

Arch Surg. 1987;122(9):1034-1035.

Abstract
• In surveillance of 75 patients receiving renal transplants in 1984 at our Institution, five cases of Pneumocystis carinii pneumonia were detected. All five cases occurred in a subgroup of 11 patients who had received cyclosporine. A retrospective epidemiologic survey of the infected patients revealed all five were heterosexual white men with onset of Pneumocystis pneumonia two to six months after cadaveric transplantation. All received cyclosporine and corticosteroids, and four of five patients also received azathioprine; none was neutropenic or had evidence of concurrent cytomegalovirus infection. Only one of these patients responded to therapy with sulfamethoxazole and trimethoprim, one patient responded to pentamidine therapy, and the remaining three patients died. Cyclosporine use may be related to development of Pneumocystis infections that are refractory to conventional antiprotozoal therapy, and transplantation programs should closely survey patients for such complications.

(Arch Surg 1987;122:1034-1035)

Author Affiliations
From the Departments of Medicine (Drs Franson and Lemann), Surgery (Drs Kauffman, Adams, and Cabrera), and Infection Control (Ms Hanacik), Froedtert Memorial Lutheran Hospital, Medical College of Wisconsin, Milwaukee. Dr Franson is now with Lilly Research Laboratories, Indianapolis.

Footnotes
Accepted for publication Oct 22, 1986.

Reprint requests to Chemotherapy, MC754, 31/3, Lilly Research Laboratories, Lilly Corp Center, Indianapolis, IN 46285 (Dr Franson).

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