Pneumocystis carinii pneumonia in Diamond-Blackfan anemia: The necessity of chemoprophylaxis for young infants

Two infants with Diamond-Blackfan anemia (DBA) developed Pneumocystis carinii pneumonia during corticosteroid (CS) therapy. Both patients showed the typical prodrome of tachypnea and fever, and the chest X-ray findings of interstitial infiltration, along with high serum levels of β-D-glucan and undetectable levels of endotoxin. The PCR study of bronchoalveolar lavage fluid was positive for P. carinii DNA in a 4-month-old infant, although it was not available in the previous case of a 2-month-old infant. No other causative agents were defined. They had no predisposing immunodeficiency diseases. Prophylaxis against P. carinii infection must be considered for young infants with DBA during the first CS therapy.