PNEUMOCYSTIS pneumonia (PCP) is among the most common opportunistic infections in patients with acquired immune deficiency syndrome (AIDS). Although trimetho-prim-sulfamethoxazole (TMP-SMX) is the first line therapy for that condition given its efficacy

approximately one third of patients experienced dose-limiting toxicity.For cases of severe to moderate PCP

if TMP-SMX treatment fails or is contraindicated

primaquine combined with clindamycin or intravenous pentamidine is recommended as second line therapy. However

both primaquine and pentamidine are associated with severe adverse reactions and often unavailable at hospitals in China.As a result

other treatment options have been explored. Caspofungin

an echinocandin

has broad antifungal activity against a wide range of fungi including Candida and Aspergillus species. Cases of PCP patients treated with caspofungin have been reported

although conflicting conclusions have been arrived at. In addition

the use of caspofungin and clindamycin as the first line therapy for severe PCP in AIDS patients has not been reported yet. This article described an AIDS case with severe PCP

treated with the combination of caspofungin and clindamycin.