Pneumocystis carinii pneumonia in a patient with stage IV ovarian cancer.

BACKGROUND

Immunocompromised persons are considered to be at risk of developing Pneumocystis carinii pneumonia, although the incidence of this condition is much lower compared to the human immunodeficiency virus-positive group. It is important to identify specific individuals at high clinical risk to guide the chemoprophylaxis of P. carinii pneumonia.

CASE: A 42-year-old female with stage IV ovarian cancer developed P. carinii pneumonia during radiotherapy for brain metastasis while receiving 7 weeks of prednisolone. Four weeks before the diagnosis, her lymphocyte count dropped to 350/microl. She was treated with pentamidine followed by trimethoprim-sulfamethoxazole with the support of mechanical ventilation. The patient could then be weaned from mechanical ventilatory support. However, she was not able to receive any additional therapy for her ovarian cancer.

CONCLUSION

Cancer patients who receive corticosteroids during chemotherapy or radiation therapy are at risk of developing P. carinii pneumonia and should receive P. carinii pneumonia prophylaxis.