Pneumocystis jirovecii Pneumonia in a Patient with Breast Cancer Receiving Neoadjuvant Dose-dense Chemotherapy.

Abstract

We herein report a 38-year-old woman with breast cancer who developed Pneumocystis jirovecii pneumonia (PCP) during neoadjuvant dose-dense chemotherapy combined with dexamethasone as antiemetic therapy. Chest computed tomography showed bilateral ground-glass opacities and consolidation. The serum β-D-glucan levels were elevated, and P. jirovecii DNA was detected from the bronchoalveolar lavage fluid by polymerase chain reaction. Her clinical findings improved with trimethoprim/sulfamethoxazole and adjunctive steroid therapy. Clinicians must be mindful of the manifestations of PCP in non-human immunodeficiency virus (HIV)-infected immunocompromised patients and include the possibility of PCP in the differential diagnosis when confronted with breast cancer on dose-dense chemotherapy showing diffuse lung disease.

• Authors: Hirofumi Watanabe, Yoshihiro Kitahara, Yurina Murakami, Fumiya Nihashi, Sayomi Matsushima, Tatsuru Eifuku, Tomohiro Uto, Jun Sato, Shiro Imokawa, Takafumi Suda
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 59 Issue 7 Pg. 987-990 (Apr 01 2020) ISSN: 1349-7235 [Electronic] Japan
• PMID: 31839658 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Anti-Bacterial Agents
• Antineoplastic Agents

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Anti-Bacterial Agents (therapeutic use)
• Antineoplastic Agents (adverse effects, therapeutic use)
• Breast Neoplasms (drug therapy)
• Female
• Humans
• Neoadjuvant Therapy (adverse effects)
• Pneumocystis carinii (isolation & purification)
• Pneumonia, Pneumocystis (chemically induced, diagnosis, drug therapy, physiopathology)
• Treatment Outcome