title: Intestinal perforation due to concomitant cytomegalovirus infection during treatment for Pneumocystis jirovecii pneumonia in a patient with rheumatoid arthritis.
abstract: A 78-year-old woman with rheumatoid arthritis treated with methotrexate and corticosteroid was admitted to our hospital for dry cough and dyspnea. She was diagnosed as having Pneumocystis pneumonia based on elevated beta-D-glucan and positive PCR analysis of bronchoalveolar lavage fluid for Pneumocystis jirovecii. We started trimethoprim-sulfamethoxazole and high-dose corticosteroid therapy. Her pulmonary lesions gradually improved; however, she developed perforation of the ileum and subsequently died from sepsis. Histology of the perforated site was compatible with cytomegalovirus enterocolitis.
authors: Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan.
authors: Takashi
authors: T
authors: Ishiguro
authors: Noboru
authors: N
authors: Takayanagi
authors: Yoshinori
authors: Y
authors: Kawabata
authors: Yutaka
authors: Y
authors: Sugita
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D008727:Methotrexate / Q000627:therapeutic use; D045363:Pneumocystis carinii / Q000302:isolation & purification*; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D008727:Methotrexate