内容紹介
Summary
A 63-year-old man was diagnosed with advanced sigmoid cancer of pT3, pN0, sM1c, sP3, fStage Ⅳ post-operation. After CAPOX plus Bmab as the first-line chemotherapy, he underwent IRIS plus Bmab as the second-line chemotherapy. After 1 course of IRIS plus Bmab, he was admitted to the hospital for fever, dyspnea, and general fatigue. The white blood cell count was 6.2×103/μL, and the C-reactive protein was elevated to 12.9 mg/dL. The PaO2 of the artery blood gas analysis in room air was 46.3 mmHg, suggesting respiratory failure. He was diagnosed with PCP based on the bilateral diffused ground-glass opacities on chest CT along with an elevated serum β-D-glucan. The treatment of trimethoprim-sulfamethoxazole and steroid was then initiated. After the patient's clinical condition improved, he was discharged on day 27 post-admission.
要旨
症例は63歳,男性。S状結腸癌術後腹膜播種に対して一次治療としてCAPOX+Bmab施行後,二次治療としてIRIS+Bmab療法を開始した。1コース施行後,発熱,呼吸苦および全身倦怠感が出現し,精査加療目的に緊急入院した。血液検査所見ではWBC 6.2×10 3 /μL,CRP 12.9 mg/dLと炎症反応の上昇を認めた。動脈血液ガス分析(room air)ではPaO2 46.3 mmHgと急性呼吸不全の状態であった。胸部CTにて両肺上葉にすりガラス状陰影を認めた。β-D-glucan高値であることから,ニューモシスチス肺炎(pneumocystis pneumonia: PCP)と診断した。ST合剤およびステロイド投与にて改善し,第27病日に退院した。
目次
A 63-year-old man was diagnosed with advanced sigmoid cancer of pT3, pN0, sM1c, sP3, fStage Ⅳ post-operation. After CAPOX plus Bmab as the first-line chemotherapy, he underwent IRIS plus Bmab as the second-line chemotherapy. After 1 course of IRIS plus Bmab, he was admitted to the hospital for fever, dyspnea, and general fatigue. The white blood cell count was 6.2×103/μL, and the C-reactive protein was elevated to 12.9 mg/dL. The PaO2 of the artery blood gas analysis in room air was 46.3 mmHg, suggesting respiratory failure. He was diagnosed with PCP based on the bilateral diffused ground-glass opacities on chest CT along with an elevated serum β-D-glucan. The treatment of trimethoprim-sulfamethoxazole and steroid was then initiated. After the patient's clinical condition improved, he was discharged on day 27 post-admission.
要旨
症例は63歳,男性。S状結腸癌術後腹膜播種に対して一次治療としてCAPOX+Bmab施行後,二次治療としてIRIS+Bmab療法を開始した。1コース施行後,発熱,呼吸苦および全身倦怠感が出現し,精査加療目的に緊急入院した。血液検査所見ではWBC 6.2×10 3 /μL,CRP 12.9 mg/dLと炎症反応の上昇を認めた。動脈血液ガス分析(room air)ではPaO2 46.3 mmHgと急性呼吸不全の状態であった。胸部CTにて両肺上葉にすりガラス状陰影を認めた。β-D-glucan高値であることから,ニューモシスチス肺炎(pneumocystis pneumonia: PCP)と診断した。ST合剤およびステロイド投与にて改善し,第27病日に退院した。