T-Cell Deficiency in Dual Infection With Cytomegalovirus and Pneumocystis jiroveci Pneumonia

We report a previously healthy infant presenting with cytomegalovirus (CMV) pneumonia and Pneumoncystis jiroveci (PJP) pneumonia. Immune suppression was primarily caused by perinatal CMV infection with a significant contribution by systemic steroid therapy. The potential role of CMV infection in the development of (usually transient) immunodeficiency in young children is reviewed. The complex interaction of CMV infection and the immune effects of steroids with host defense in young children are reviewed. Other factors that may contribute to immune suppression or affect outcome in dual infection with CMV and PJP are discussed.