Pneumocystis Pneumonia during Adjuvant Chemotherapy for Advanced Colon Cancer - A Case Report

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 mF...

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Published inGan to kagaku ryoho Vol. 42; no. 11; p. 1423
Main Authors Fujiwara, Yushi, Lee, Shigeru, Kishida, Satoru, Hashiba, Ryoya, Gyobu, Ken, Osugi, Harushi
Format Journal Article
LanguageJapanese
Published Japan 01.11.2015
Subjects
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemotherapy, Adjuvant
Humans
Liver Neoplasms - drug therapy
Liver Neoplasms - secondary
Lung Neoplasms - drug therapy
Lung Neoplasms - secondary
Male
Neoplasm Staging
Pneumonia, Pneumocystis - drug therapy
Pneumonia, Pneumocystis - etiology
Sigmoid Neoplasms - drug therapy
Sigmoid Neoplasms - pathology
Sigmoid Neoplasms - surgery
Tomography, X-Ray Computed
Treatment Outcome
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Summary: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.
ISSN:0385-0684