Kansenshogaku Zasshi
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
A Case of Pneumocystis carinii Pneumonia Successfully Treated with Co-trimoxazole and Pentamidine for Intravenous Injection
Junko HIBINOTakeshi MORIHideo IKEMOTOKouichi ISHIMOTOYutaka FUKUDAMasafumi KANEKO
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1985 Volume 59 Issue 5 Pages 500-506

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Abstract

This report relates to a case of Pneumocystis carinii pneumonia successfuly treated with a combination of co-trimoxazole for intravenous injection (i. v.) and pentamidine isethionate.
A 13 years old boy was admitted with a malignant lymphoma to Juntendo University Hospital. He had a local radiological therapy at his cervical lymphnodes and a systemic VEMP therapy. His condition was improved.
On the day of his discharge, a marked leucopenia was found and he had to be readmitted on the following day.
He started an antibiotic therapy, but his pharyngalgia was aggravated and his body temperature tended to rise up, and so the antibiotic was changed to other one. In spite of the treatment, his condition was not improved.
Chest x-ray examination on the 10th hospital day showed diffuse shadows in the bilateral lung fields and a marked hypoxemia developed. A presumptive diagnosis of Pneumocystis carinii pneumonia was made and he was given intravenously co-trimoxazole for 4 days. A smear test of sputum disclosed a cyst of P. carinii. So a combination of co-trimoxazole and pentamidine for i.v. was given for 8 days.
His high fever tended to fall down and hypoxemia was disappeared 9 days after the initiation of the therapy.
The combination therapy with both drugs for i.v. was stopped and an oral administration of cotrimoxazole only was continued during 120 days. There was no sign of reccurrence thereafter.
The patient recovered from Pneumocystis carinii pneumonia by combined remedy with cotrimoxazole for i. v. and pentamidine for i. v. Considering his clinical course, he was expected his noticeable effect even if co-trimoxazole for i.v. alone was given from the beginning of his illness.
Co-trimoxazole for i. v. has not been available yet in Japan. This patient may be the first case treated with co-trimoxazole for i.v. in Japan.

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© The Japansese Association for Infectious Diseases
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