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

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-...

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Bibliographic Details
Published in:Internal Medicine 2020/04/01, Vol.59(7), pp.987-990
Main Authors: Watanabe, Hirofumi, Kitahara, Yoshihiro, Murakami, Yurina, Nihashi, Fumiya, Matsushima, Sayomi, Eifuku, Tatsuru, Uto, Tomohiro, Sato, Jun, Imokawa, Shiro, Suda, Takafumi
Format: Article
Language:English
Subjects:
Alveoli
Breast cancer
bronchoalveolar lavage
Bronchus
Case Report
Chemotherapy
chest CT
Computed tomography
Dexamethasone
Differential diagnosis
drug-induced pneumonitis
HIV
Human immunodeficiency virus
Immunocompromised hosts
Internal medicine
Lung diseases
Pneumocystis jirovecii
Pneumonia
Polymerase chain reaction
Sulfamethoxazole
Trimethoprim
β-D-glucan
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Summary: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.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.3907-19