Pharmaceutical care of one case of pneumocystis yersoni pneumonia secondary to autoimmune hepatitis complicated with primary biliary cholangitis
A female patient who has been diagnosed as suffering from pneumocystis yersoni pneumonia secondary to primary biliary cholangitis(PBC)complicated with autoimmune hepatitis(AIH)was admitted due to intermittent skin pruritus for 8 years and fever for 20 days.She had been diagnosed with PBC and AIH more than 3 months ago and has received glucocorticoid therapy since then.After admission,the patient was diagnosed as suffering from respiratory distress syndrome,severe pneumonia,primary biliary cirrhosis and autoimmune hepatitis.Piperacillin sodium was given to her by doctors according to clinical experience,then the medicine was changed to trimethoprim-sulfamethoxazole and carpofungin based on the result of next-generation sequencing(NGS)of bronchoalveolar lavage fluid showing infection by pneumocystis jirovecii.Meanwhile,clinical pharmacists made individualized regimens by adjusting anti-infection drugs and carry out pharmaceutical monitoring on the therapeutic efficacy and adverse reactions.The patient was educated on medication,life and diet.Finally,she was discharged with a good prognosis.Autoimmune liver diseases are high risk factors for secondary pneumocystis yerbii pneumonia and has a high mortality.This paper summarized the important role of clinical pharmacists in comprehensively evaluating patients'disease status,drug use and test results,and cooperating with clinicians to develop rational and individualized drug treatment plans to improve the safety,effectiveness and economy of drug treatment.Establishing good communication with doctors is helpful for improving patients'trust in pharmacists.Clinical pharmacists actively participate in the pharmaceutical management of critically ill patients can guarantee the safe and effective treatment of patients and significantly improve the clinical prognosis.
Pneumocystis jirovecii pneumoniaAutoimmune hepatitisPrimary biliary cholangitisClinical pharmacistPharmaceutical care
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