title: [Pneumocystis Pneumonia during Adjuvant Chemotherapy for Advanced Colon Cancer - A Case Report].
abstract: We report a case of pneumocystis pneumonia (PCP) during adjuvant chemotherapy for advanced sigmoid colon cancer. A 70-year-old Japanese man was referred to our hospital after complaining of bloody stools. He was diagnosed with advanced sigmoid colon cancer, T2N2aM1b, Stage IV B. After 3 cycles of mFOLFOX6 plus panitumumab as first-line chemotherapy, he received FOLFIRI plus bevacizumab as second-line chemotherapy because of progressive disease. Aprepitant and steroids were administered as antiemetic agents for a short period during each chemotherapy session. During the 2 cycle of FOLFIRI plus bevacizumab, he developed a high fever without respiratory symptoms. Chest CT revealed ground-glass opacities in both the lungs. We first treated him with antibiotics (PIPC/TAZ plus GRNX), suspecting bacterial pneumonia. However, based on the elevation of serum b -D-glucan (148 pg/mL), we diagnosed PCP and initiated SMX/TMP in addition to PIPC/TAZ. The inflammation promptly decreased, and follow-up chest CT revealed the disappearance of the ground-glass opacities. If a patient develops a fever or respiratory symptoms during a course of chemotherapy, we should consider the possibility of PCP and perform careful examinations.
authors.affiliation: Dept. of Gastroenterological Surgery, Osaka City University Graduate School of Medicine.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Shigeru
authors.initials: S
authors.lastname: Lee
authors.forename: Satoru
authors.initials: S
authors.lastname: Kishida
authors.forename: Ryoya
authors.initials: R
authors.lastname: Hashiba
authors.forename: Ken
authors.initials: K
authors.lastname: Gyobu
authors.forename: Harushi
authors.initials: H
authors.lastname: Osugi
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D009367:Neoplasm Staging; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy* / Q000209:etiology; D012811:Sigmoid Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome