2007 Volume 47 Issue 3 Pages 273-276
Background. When chest radiographs of lung cancer patients undergoing chemotherapy show diffuse light interstitial infiltrates, we have difficulty in distinguishing the pneumonia from a drug allergy. Cases. We reported 3 occurrences of Pneumocystis pneumonia in lung cancer patients. The patients, 73-, 72-, and 55-year-old men, were undergoing chemotherapy. One had received long-term corticosteroid treatment. The others had received only chemotherapy, so we hypothesized chemotherapy was also a risk factor in the occurrence of Pneumocystis pneumonia. All had fevers, but only 1 developed respiratory failure. All chest radiographs showed diffuse light interstitial infiltrates. In all cases Pneumocystis was detected in bronchoalveolar lavage fluid or sputum by polymerase chain reaction. β-D-glucan concentrations were elevated high. The patients were treated with sulfamethoxazole-trimethoprim, and all showed marked improvement. Conclusion. When chest radiographs of lung cancer patients undergoing chemotherapy show diffuse light interstitial infiltrates, Pneumocystis pneumonia should be considered.
