Pneumocystis jirovecii Pneumonia in a Non-small Cell Lung Cancer Patient on Chemoradiotherapy: A Case Report
Pneumocystis jirovecii Pneumonia in a Non-small Cell Lung Cancer Patient on Chemoradiotherapy: A Case Report
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DOI：
10.4103/sjmms.sjmms_255_18
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发表时间：
2020-01-01
影响因子：
1.6
通讯作者：
Valdivia, Javier
中科院分区：
文献类型：
--
作者：
Doello, Kevin;Amezcua, Victor;Valdivia, Javier
肺囊虫肺炎是肺癌患者中一种非常罕见的并发症。我们报告一例59岁的IIIB期非小细胞肺癌（表皮样）患者，同时接受化疗方案（顺铂+维诺瑞滨）和放疗，出现经典抗生素无法控制的发热和呼吸困难。病人出现呼吸窘迫。高分辨率计算机断层扫描显示疯狂铺路模式，支气管肺泡灌洗证实诊断为乙氏肺囊虫肺炎。患者静脉注射甲氧苄氨嘧啶/磺胺甲恶唑和伏立康唑治疗成功。文献中很少有这样的病例报道，在大多数情况下，感染已被发现与积极的肿瘤治疗有关。因此，在有其表现症状的肺癌患者中，尤其当患者正在接受积极的化疗和/或放疗时，应考虑乙氏肺囊虫肺炎。
Pneumocystis jirovecii pneumonia is a very uncommon complication in lung cancer patients. We report the case of a 59-year-old, Stage IIIB non-small cell lung cancer (epidermoid) patient who was receiving concurrent chemotherapy scheme (cisplatin + vinorelbine) and radiotherapy and developed fever and dyspnea not controlled with classical antibiotics. The patient developed respiratory distress. A high-resolution computed tomography showed a crazy-paving pattern, and a bronchoalveolar lavage confirmed the diagnosis of Pneumocystis jirovecii pneumonia. The patient was successfully managed with intravenous trimethoprim/sulfamethoxazole and voriconazole. Few such cases have been reported in the literature, and in most cases, the infection has been found to be associated with aggressive oncological treatments. Therefore, Pneumocystis jirovecii pneumonia should be considered in lung cancer patients with its presenting symptoms, especially if the patient is undergoing aggressive chemotherapy and/or radiotherapy.