[A case of pneumocystis pneumonia during chemotherapy for gastric cancer].

Abstract

We report a death case of a man in his sixties with pneumocystis pneumonia during chemotherapy for gastric cancer. He was diagnosed with cStage IIIB (T4a, N2, H0, P0, M0). Because of bulky N2, systemic chemotherapy of S-1 and CDDP was performed from April 2009. But no reductions were noted after 2 courses. We next treated this patient with S-1 and CPT-11. He had also received corticosteroid treatment for nausea. Because of high fever and choke, he came to our hospital at day 12 in 3 courses, and a severe respiratory failure occurred. CT of the chest showed diffuse ground-glass bilateral opacities, and we immediately started a treatment with trimethoprim-sulfamethozazole and corticosteroid for the possibility of pneumocystis pneumonia. We finally deduced pneumocystis pneumonia from markedly elevated serum beta-D-glucan and PCR positive after hospitalization. In spite of early treatments, he died of bacterial pneumonia and gastric cancer. We should be careful of pneumocystis pneumonia during chemotherapy and corticosteroid treatment.

• Authors: Masaaki Miyo, Shohei Iijima, Yoichi Makari, Mitsuhiro Yamaguchi, Aya Kato, Takuya Sakamoto, Takashi Doi, Minako Hoshi, Yasuhiro Miyake, Satoshi Oshima, Takeshi Kato, Eiji Kurokawa, Nobuteru Kikkawa, Osamu Kojima
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 37 Issue 12 Pg. 2412-4 (Nov 2010) ISSN: 0385-0684 [Print] Japan
• PMID: 21224590 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents, Phytogenic
• Drug Combinations
• Glucocorticoids
• S 1 (combination)
• Tegafur
• Oxonic Acid
• Irinotecan
• Dexamethasone
• Trimethoprim, Sulfamethoxazole Drug Combination
• Camptothecin

Topics

• Antineoplastic Agents, Phytogenic (administration & dosage)
• Camptothecin (administration & dosage, analogs & derivatives)
• Dexamethasone (therapeutic use)
• Drug Combinations
• Fatal Outcome
• Glucocorticoids (therapeutic use)
• Humans
• Irinotecan
• Male
• Middle Aged
• Oxonic Acid (administration & dosage)
• Pneumonia, Pneumocystis (complications, drug therapy)
• Stomach Neoplasms (complications, drug therapy)
• Tegafur (administration & dosage)
• Trimethoprim, Sulfamethoxazole Drug Combination (therapeutic use)