title: [Pneumocystis pneumonia in a patient treated with pemetrexed for non small cell lung cancer].
abstract: BACKGROUND
  Pneumocystis pneumonia is a life-threatening infection in patients undergoing chemotherapy for solid malignancies.
  
  
  METHODS
  A 49-year-old man developed gradually increasing dyspnoea while receiving pemetrexed as a third line treatment for an adenocarcinoma of the lung. The diagnosis of pneumocystis pneumonia was based on ground-glass opacities on the thoracic CT scan and alveolar lavage revealing occasional cysts of Pneumocystis jiroveci in the context of recent lymphopenia developing during chemotherapy. Treatment with cotrimoxazole for three weeks was only partially successful due to progression of the tumour.
  
  
  CONCLUSIONS
  Pneumocystis pneumonia should be considered in cancer patients receiving antifolate drugs and presenting with increasing dyspnoea. It is important to identify a high-risk population among patients undergoing chemotherapy because of the significant morbidity and mortality and in order to administer effective prophylactic agents.
authors.affiliation: Service de Pneumologie A, Centre de Compétences des Maladies Pulmonaires Rares, Hôpital Bichat, Assistance Publique des Hôpitaux de Paris, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.
authors.forename: M
authors.initials: M
authors.lastname: Neuville
authors.forename: R
authors.initials: R
authors.lastname: Borie
authors.forename: J-M
authors.initials: JM
authors.lastname: Rodier
authors.forename: M-P
authors.initials: MP
authors.lastname: Debray
authors.forename: C
authors.initials: C
authors.lastname: Danel
authors.forename: M-C
authors.initials: MC
authors.lastname: Dombret
authors.forename: M
authors.initials: M
authors.lastname: Aubier
authors.forename: B
authors.initials: B
authors.lastname: Crestani
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000935:Antifungal Agents / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use / Q000633:toxicity*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use / Q000633:toxicity; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D018450:Disease Progression; D005500:Follow-Up Studies; D005971:Glutamates / Q000627:therapeutic use / Q000633:toxicity*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use / Q000633:toxicity; D006801:Humans; D007262:Infusions, Intravenous; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis*; D000068437:Pemetrexed; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis* / Q000188:drug therapy; D019233:Retreatment; D014057:Tomography, X-Ray Computed; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D015662:Trimethoprim, Sulfamethoxazole Drug Combination