Infectious Diseases and Intensive Care Unit, CHU Rennes, Rennes, France.
Department of Respiratory Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France.
BMJ Case Rep. 2021 Jun 28;14(6):e232895. doi: 10.1136/bcr-2019-232895.
Lung cancer prognosis has improved in the last decade, including in patients with brain metastasis. However, few of these patients who receive corticosteroids have a primary prophylaxis for pneumonia (PJP). We report the case of an 80-year-old man diagnosed with non-small cell lung cancer and concomitant symptomatic brain metastases, treated with 50 mg/day of prednisolone without any prophylaxis, who presented an acute PJP. After 72 hours of unsuccessful treatment of PJP, the patient died. In our review of this case and the existing literature, we emphasise the importance of a wide use of prophylaxis for PJP, especially in advanced lung cancer treated with corticosteroid therapy. We discuss this issue and report current evidence for primary prophylaxis by trimethoprim-sulfamethoxazole.
在过去的十年中，肺癌的预后得到了改善，包括脑转移患者。然而，在接受皮质类固醇治疗的这些患者中，很少有人接受肺炎（PCP）的一级预防。我们报告了一例 80 岁男性，诊断为非小细胞肺癌合并有症状的脑转移，接受 50mg/天泼尼松龙治疗而无任何预防措施，出现急性 PCP。在对 PCP 的治疗 72 小时后无效，患者死亡。在我们对该病例和现有文献的回顾中，我们强调了广泛使用 PCP 预防的重要性，特别是在接受皮质类固醇治疗的晚期肺癌中。我们讨论了这个问题，并报告了目前使用复方磺胺甲噁唑进行一级预防的证据。
