A case of Pneumocystis carinii pneumonia with bronchial asthma following long-term corticosteroid therapy

A 50-year-old man, who developed bronchial asthma at the age of 43 and was treated continuously with corticosteroids from the beginning of the first treatment, was admitted with exacerbation of exertional dyspnea. In spite of various treatments for bronchial asthma, such as theophylline, beta-stimulants, anti-allergic drugs and steroid-inhalation, asthmatic symptoms did not improve and he continued to receive intravenous administration of steroids. Five months after admission, he suddenly developed severe respiratory failure and died after five days. Autopsy revealed Pneumocystis carinii pneumonia and marked atrophy of adrenal glands. No evidence of malignancy or hematologic disease was seen. Serum HIV antibody was negative. Secondary immunodeficiency induced by long-term corticosteroid administration of over 7 years was considered to be the cause of Pneumocystis carinii pneumonia. It seems that no case of Pneumocystis carinii pneumonia with bronchial asthma alone has ever been reported in medical literature.