PNEUMOCYSTIS-CARINII PNEUMONIA DURING TREATMENT FOR RECURRENT BREAST-CANCER - A CASE-REPORT

We describe a case of Pneumocystis carinii pneumonia (PCP) in a woman with recurrent breast cancer without human immunodeficiency virus (HIV ) infection. The PCP was associated with severe lymphocytopenia due to treatment with anticancer agents in combination with granulocyte colo ny-stimulating factor (G-CSF). Despite the severe lymphocytopenia, the total leucocyte count never fell below 3000/mm(3) during the treatmen t. It was difficult to determine whether the patient's respiratory fai lure was caused by severe infectious pneumonia, hypersensitivity pneum onia or pneumonitis carcinomatosis. She was treated with steroid for s uspected drug-induced hypersensitivity pneumonia. However, as her cond ition did not improve, PCP was suspected, and sulfamethoxazole-trimeth oprim was administered. At the same time, anticancer drugs were admini stered to half the progression of the cancer, since lymphangitis carci nomatosa was also suspected, The severe respiratory failure did not im prove, and the patient died on day 23 after admission. At autopsy, the cause of death was confirmed to be respiratory failure due to PCP.