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[Pneumocystis pneumonia in a patient treated with pemetrexed for non small cell lung cancer]
M Neuville1, R Borie, J-M Rodier
1Service 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.
Introduction:
Pneumocystis pneumonia is a life-threatening infection in patients undergoing chemotherapy for solid malignancies.
Case Report:
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.
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