Pneumocystis Pneumonia in Solid Organ Transplant Recipients

Pneumocystis pneumonia (PCP) remains an important opportunistic infection among solid organ transplant (SOT) recipients. The diagnosis of PCP should be considered in patients with new onset of fever, pulmonary symptoms, and hypoxemia. The introduction of PCP prophylaxis for SOT recipients has dramatically modified the epidemiological landscape of this infection; we are currently experiencing the era of “late PCP,” where the majority of cases occur more than 12 months after transplantation in patients with PCP risk factors in whom prophylaxis has been discontinued. Despite remarkable advancement in our understanding of the biology, mode of transmission, epidemiology, and clinical manifestations of PCP, there remains a paucity of data regarding the performance of contemporary diagnostic tools for PCP in transplant recipients. Although there is a low incidence of PCP in this population, associated morbidity and mortality may be high, necessitating additional studies aimed at diagnosis.