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Unsuspected Pneumocystis pneumonia in an HIV-seronegative patient with untreated lung cancer: circa case report.

Chuang C, Zhanhong X, Yinyin G, Qingsi Z, Shuqing Z, Nanshan Z - J Med Case Rep (2007)

Bottom Line: A 43-year-old woman presented with prolonged fever, progressive dyspnoea, diffuse alveolar and interstitial infiltrates.Malignant cells were found on sputum cytology, confirming the diagnosis of lung cancer.Pneumocystis jiroveci was later found in the sputum but she proved to be HIV negative.

View Article: PubMed Central - HTML - PubMed

Affiliation: Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510012, China, . skinblack1966@yahoo.com.cn.

ABSTRACT

Background: Patients with solid malignant tumours are at increased risk of Pneumocystis jiroveci infection from immunosuppression as a result of chemotherapy and/or radiotherapy, but active Pneumocystis pneumonia (PCP) in untreated lung cancer is uncommon.

Case presentation: A 43-year-old woman presented with prolonged fever, progressive dyspnoea, diffuse alveolar and interstitial infiltrates. Malignant cells were found on sputum cytology, confirming the diagnosis of lung cancer. She had been treated with corticosteroids and antibiotics but did not receive chemotherapy or radiotherapy. Pneumocystis jiroveci was later found in the sputum but she proved to be HIV negative.

Conclusion: Unsuspected PCP can occur in chemotherapy and radiotherapy-naïve, HIV-seronegative patients with lung cancer. The complex clinicoradiological manifestations of PCP with underlying lung cancer can lead to delay in diagnosis and may worsen the prognosis.

No MeSH data available.


Related in: MedlinePlus

Chest CT displaying diffuse nodular parenchymal infiltrates with partial confluence.
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Figure 2: Chest CT displaying diffuse nodular parenchymal infiltrates with partial confluence.

Mentions: Chest radiograph (Fig. 1) revealed diffuse nodular and patchy consolidations with predominance in the lower lung fields, and right hilar expansion. Chest CT scanning (Fig. 2) demonstrated diffuse alveolar and interstitial infiltrates with partial confluence and adenopathy in both hilar regions. CT angiography was negative for pulmonary embolism.


Unsuspected Pneumocystis pneumonia in an HIV-seronegative patient with untreated lung cancer: circa case report.

Chuang C, Zhanhong X, Yinyin G, Qingsi Z, Shuqing Z, Nanshan Z - J Med Case Rep (2007)

Chest CT displaying diffuse nodular parenchymal infiltrates with partial confluence.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2147019&req=5

Figure 2: Chest CT displaying diffuse nodular parenchymal infiltrates with partial confluence.
Mentions: Chest radiograph (Fig. 1) revealed diffuse nodular and patchy consolidations with predominance in the lower lung fields, and right hilar expansion. Chest CT scanning (Fig. 2) demonstrated diffuse alveolar and interstitial infiltrates with partial confluence and adenopathy in both hilar regions. CT angiography was negative for pulmonary embolism.

Bottom Line: A 43-year-old woman presented with prolonged fever, progressive dyspnoea, diffuse alveolar and interstitial infiltrates.Malignant cells were found on sputum cytology, confirming the diagnosis of lung cancer.Pneumocystis jiroveci was later found in the sputum but she proved to be HIV negative.

View Article: PubMed Central - HTML - PubMed

Affiliation: Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510012, China, . skinblack1966@yahoo.com.cn.

ABSTRACT

Background: Patients with solid malignant tumours are at increased risk of Pneumocystis jiroveci infection from immunosuppression as a result of chemotherapy and/or radiotherapy, but active Pneumocystis pneumonia (PCP) in untreated lung cancer is uncommon.

Case presentation: A 43-year-old woman presented with prolonged fever, progressive dyspnoea, diffuse alveolar and interstitial infiltrates. Malignant cells were found on sputum cytology, confirming the diagnosis of lung cancer. She had been treated with corticosteroids and antibiotics but did not receive chemotherapy or radiotherapy. Pneumocystis jiroveci was later found in the sputum but she proved to be HIV negative.

Conclusion: Unsuspected PCP can occur in chemotherapy and radiotherapy-naïve, HIV-seronegative patients with lung cancer. The complex clinicoradiological manifestations of PCP with underlying lung cancer can lead to delay in diagnosis and may worsen the prognosis.

No MeSH data available.


Related in: MedlinePlus