Cotrimoxazole Pneumocystis jiroveci pneumonia treatment failure:: co-infection cytomegalovirus role?

Pneumocystis jiroveci pneumonia is a classic opportunist infection affecting AIDS patients. However it is less frequent since systematic prophylaxis and antiretroviral therapies. Treatment resistance is rare in France. We report the case of a severe Pneumocystis firoveci pneumonia with treatment resistance to standard treatment and fatal outcome. The different causes of treatment resistance, notably the role of CMV coinfection, were reviewed and discussed. (c) 2007 Elsevier Masson SAS. Tous droits reserves.