Pneumocystis jirovecii Pneumonia in Three Patients With Breast Cancer Receiving Neoadjuvant Dose-Dense Chemotherapy

We report three cases of pneumonia (PJP) during dose-dense neoadjuvant chemotherapy for breast cancer. All patients presented with symptoms (e.g., fever), and computed tomography showed diffuse ground-glass shadows. Bronchoalveolar lavage was performed, and the diagnosis was confirmed by polymerase...

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Published inCurēus (Palo Alto, CA) Vol. 14; no. 2; p. e21812
Main Authors Shiiba, Ritsuya, Himeji, Daisuke, Matsumoto, Ryoichi, Tanaka, Gen-Ichi, Otomo, Naoki
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 01.02.2022
Cureus
Subjects
Auscultation
Blood pressure
Breast cancer
Bronchoscopy
Cancer therapies
Case reports
Chemotherapy
Drug dosages
Fever
Granulocytes
HIV
Human immunodeficiency virus
Infectious Disease
Laboratories
Lymphocytes
Mortality
Neutrophils
Oncology
Pneumonia
Proteins
Pulmonology
Steroids
Surfactants
Tomography
Japan
dose-dense chemotherapy
neoadjuvant chemotherapy
breast cancer
lymphocytopenia
pneumocystis jirovecii pneumonia
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Summary:We report three cases of pneumonia (PJP) during dose-dense neoadjuvant chemotherapy for breast cancer. All patients presented with symptoms (e.g., fever), and computed tomography showed diffuse ground-glass shadows. Bronchoalveolar lavage was performed, and the diagnosis was confirmed by polymerase chain reaction for  . All patients had completed three or four courses of dose-dense epirubicin-cyclophosphamide chemotherapy and received prednisolone for preventing chemo-induced nausea and vomiting. Moreover, lymphocytopenia was observed in all patients. Since the onset of PJP in preoperative neoadjuvant chemotherapy can be life-threatening and leads to delayed surgery, careful consideration of prophylaxis for PJP is required.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.21812