Table 2.
Schema of events from maternal diagnosis of B-cell lymphoma, the birth of the infant, and readmission for Pneumocystis pneumonia with the associated management.
| Events | Period | Treatment |
|---|---|---|
| Pregnancy | (i) 2nd trimester | (i) Diagnosed B-cell lymphoma |
| (ii) 17–33 weeks' gestation | (ii) Received 6 cycles of R-CHOP | |
|
| ||
| Birth | (i) At birth (35 weeks' gestation) | (i) Admitted to the special care unit |
| (ii) D7 | (ii) Discharged home | |
|
| ||
| Readmission | (i) 11 weeks (corrected 6 weeks) | (i) Presented to the peripheral hospital |
| (ii) D1 | (ii) High flow nasal cannula, IV ampicillin and gentamicin | |
| (a) Changed to IV cefotaxime (D1–8) | ||
| (iii) D3 | (iii) Noninvasive ventilation | |
| (a) IV azithromycin added (D3–D5) | ||
|
| ||
| Pneumocystis jirovecii diagnosis and management | (i) D4 | (i) Pneumocystis jirovecii positive on NPA; PO co-trimoxazole started |
| (ii) D8 | (ii) Changed to IV co-trimoxazole | |
| (iii) D9 | (iii) Intubated, transferred to tertiary hospital | |
| (iv) D11 | (iv) High-frequency oscillation, commenced 2nd line PCP treatment | |
|
| ||
| Further management | (i) D15 | (i) Commenced VV-ECMO |
| (ii) D16 | (ii) Bronchoscopy—positive for Pneumocystis jirovecii | |
| (iii) D46 | (iii) Decannulated to conventional ventilation | |
| (iv) D53 | (iv) Extubated to high flow | |
| (v) D103 | (v) Discharged home on supplemental oxygen | |