Pneumocystis Pneumonia in a Patient Receiving Nab-paclitaxel Plus Gemcitabine for Unresectable Pancreatic Cancer.

We herein report the first case of Pneumocystis pneumonia (PCP) in a 78-year-old man with unresectable pancreatic head cancer who was treated with nab-paclitaxel plus gemcitabine. The patient experienced fever during the second treatment course, and computed tomography revealed diffuse ground-glass opacities in the bilateral lungs. The β-D-glucan level was elevated. A polymerase chain reaction (PCR) assay of his bronchoalveolar lavage fluid specimen showed positivity for Pneumocystis jirovecii DNA. After treatment with corticosteroids and trimethoprim/sulfamethoxazole, the patient's general condition improved, followed by atovaquone. The administration of corticosteroids to prevent chemotherapy-induced nausea and vomiting (CINV) and lymphocytopenia due to chemotherapy may be therefore involved in the development of PCP.