title: [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.affiliation: Dept. of Surgery, Minoh City Hospital.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyo
authors.forename: Shohei
authors.initials: S
authors.lastname: Iijima
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Makari
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Aya
authors.initials: A
authors.lastname: Kato
authors.forename: Takuya
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Doi
authors.forename: Minako
authors.initials: M
authors.lastname: Hoshi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Satoshi
authors.initials: S
authors.lastname: Oshima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kato
authors.forename: Eiji
authors.initials: E
authors.lastname: Kurokawa
authors.forename: Nobuteru
authors.initials: N
authors.lastname: Kikkawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Kojima
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D003907:Dexamethasone / Q000627:therapeutic use; D004338:Drug Combinations; D017809:Fatal Outcome; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000188:drug therapy; D013274:Stomach Neoplasms / Q000150:complications / Q000188:drug therapy*; D005641:Tegafur / Q000008:administration & dosage; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D004338:Drug Combinations; D005938:Glucocorticoids; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000077146:Irinotecan; D003907:Dexamethasone; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D002166:Camptothecin