Abstract

Blanca E. Gonzalez,* Luis A. Faverio Francisco M. Marty Craig MacArthur and Robin B. Churchill Division of Pediatric Infectious Diseases Rainbow Babies and Children's Hospital University Hospitals Case Medical Center Cleveland, Ohio Department of Pediatrics The Children's Hospital of Southwest Florida Lee Memorial Health System Fort Myers, Florida Division of Infectious Diseases Brigham and Women's Hospital Boston, Massachusetts Department of Pediatrics The Children's Hospital of Southwest Florida Lee Memorial Health System Fort Myers, Florida LETTER Elevation of levels of serum (13) beta-D-glucan (BDG), an important cell wall component of most fungi, including Pneumocystis jirovecii, have been observed in adult patients with Pneumocystis jirovecii pneumonia (PCP), usually at levels exceeding 500 pg/ml (4, 6, 10). However, there are no reports to date on the use of this serological marker to assist in diagnosing PCP in children. We report 3 immunocompromised children who presented to the Children's Hospital of Southwest Florida with elevated serum BDG levels with confirmed (n = 1) and presumed (n = 2) PCP based on clinical presentation (Table 1). All patients were hypoxemic and developed bilateral interstitial infiltrates radiographically, which led to the suspicion of PCP. All three patients were on PCP prophylaxis with pentamidine. Two