Should prophylaxis against Pneumocystis jirovecii pneumonia be considered in selected patients with leprosy reactions?

Nuria Ramírez-Perea; Claudia Moran-Castaño; Jose A Perez-Molina

doi:10.1186/s41479-024-00127-x

Should prophylaxis against Pneumocystis jirovecii pneumonia be considered in selected patients with leprosy reactions?

Pneumonia (Nathan). 2024 Apr 5;16(1):6. doi: 10.1186/s41479-024-00127-x.

Authors

Nuria Ramírez-Perea¹, Claudia Moran-Castaño², Jose A Perez-Molina^{3

4}

Affiliations

¹ Internal Medicine Department, Elda University Hospital, Alicante, 03600, Spain. Nuriaramirez92@outlook.es.
² Internal Medicine Department, Carmen y Severo Ochoa Hospital, Asturias, Spain.
³ National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramon y Cajal University Hospital, IRYCIS, Madrid, 28034, Spain.
⁴ CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, 28029, Spain.

Abstract

Leprosy reactions often require prolonged high-dose steroids or immunosuppressive drugs, putting patients at risk of Pneumocystis jirovecii pneumonia (PJP). However, no PJP cases are reported, possibly due to dapsone treatment for leprosy. In patients with leprosy reactions not receiving dapsone because of toxicity or resistance and requiring long-term immunosuppression, PJP prophylaxis should be considered.

Keywords: Dapsone; Immunosuppression; Leprosy; Leprosy reactions; PJP prophylaxis.

Publication types

Letter