scholarly journals 402. Breakthrough Pneumocystis jirovecii Pneumonia Among Cancer Patients: Opportunity for Antimicrobial Stewardship?

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S154-S155
Author(s):  
Steven Roncaioli ◽  
Andrew Bryan ◽  
Erica Stohs ◽  
Catherine Liu ◽  
Ania Sweet ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Antimicrobial Stewardship ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia

scholarly journals Pneumocystis jirovecii Pneumonia Prophylaxis for Cancer Patients during Chemotherapy

Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 237
Author(s):  
Kazuto Takeuchi ◽  
Yoshihiro Yakushijin
Keyword(s):  
Cancer Treatment ◽  
Treatment Outcomes ◽  
Cancer Patients ◽  
Potential Problem ◽  
Corticosteroid Treatment ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Immunocompromised Patients ◽  
Healthy Individuals ◽  
Life Threatening

Pneumocystis jirovecii pneumonia (PJP) is one type of life-threatening pneumonia in immunocompromised patients. PJP development should be considered in not only immunocompromised individuals, but also patients undergoing intensive chemotherapies and immunotherapies, organ transplantation, or corticosteroid treatment. Past studies have described the clinical manifestation of PJP in patients during chemotherapy and reported that PJP affects cancer treatment outcomes. Therefore, PJP could be a potential problem for the management of cancer patients during chemotherapy, and PJP prophylaxis would be important during cancer treatment. This review discusses PJ colonization in outpatients during cancer chemotherapy, as well as in healthy individuals, and provides an update on PJP prophylaxis for cancer patients during chemotherapy.

scholarly journals Pneumocystis jirovecii Pneumonia in a Patient with Lung Adenocarcinoma and EGFR Mutation Treated with Afatinib During the Coronavirus Pandemic 2019

2020 ◽  
pp. 1-3
Author(s):  
Alessandro Morabito ◽  
Agnese Montanino ◽  
Giovanna Esposito ◽  
Giuliano Palumbo ◽  
Anna Manzo ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Cancer Patients ◽  
Pneumocystis Jirovecii ◽  
Empiric Antibiotic Therapy ◽  
Nasopharyngeal Swab ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Global Pandemic ◽  
Empiric Antibiotic ◽  
Infection Disease ◽  
Novel Coronavirus

The novel coronavirus (SARS-CoV-2) or COVID-19 pneumonia is a new global pandemic that can be a challenge for the oncologists. Cancer patients are at high risk of contracting this infection and to develop severe respiratory complications. We present the case of a young patient with a metastatic EGFR positive lung adenocarcinoma in complete remission with afatinib therapy, who developed fever, dyspnea, dry cough, widespread pain and weakness during COVID-19 pandemic in Italy. The thorax computed tomography scan showed suspected pneumonia. Empiric antibiotic therapy was initiated without significant improvement in symptoms. The differential diagnosis included COVID-19 or other pneumonia, mycotic infection, disease progression or afatinib related pneumonia. A SARS-CoV-2 test on a nasopharyngeal swab was repeated twice, and it was negative. Tests for pneumobacteria, cytomegalovirus, tuberculosis bacteria and Legionella were also negative. We further performed a bronchoscopy with bronchoalveolar lavage, and a Pneumocystis jirovecii was microscopically identified. Treatment with trimethoprim-sulfamethoxazole was initiated, with regression of all symptoms. This case confirms the growing difficulties for oncologists during COVID-19 pandemic in the proper management of cancer patients, showing the challenges due to differential diagnoses. In this context, a multidisciplinary approach is crucial to define the best diagnostic and therapeutic strategy.

Twice weekly prophylaxis with trimethoprim/sulfamethoxazole for Pneumocystis jirovecii pneumonia in pediatric oncology patients

2020 ◽  
pp. 107815522097904
Author(s):  
Monica Awad ◽  
Caroline M Sierra ◽  
Elhaam Mesghali ◽  
Khaled Bahjri
Keyword(s):  
Pediatric Oncology ◽  
Retrospective Cohort ◽  
Hematologic Malignancies ◽  
Primary Objective ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Weekly Dose ◽  
Single Center ◽  
Oncology Patients ◽  
Prophylaxis Therapy

Current recommendations for prophylaxis of Pneumocystis jirovecii pneumonia in oncology patients include administration of trimethoprim/sulfamethoxazole (TMP/SMX) three times weekly or the same total weekly dose given daily. The primary objective of this study was to evaluate the efficacy of two consecutive days per week of TMP/SMX for prevention of Pneumocystis jirovecii pneumonia (PJP) in pediatric oncology patients. A retrospective cohort, single-center analysis was conducted in oncology patients 21 years and younger who received TMP/SMX for PJP prophylaxis between February 1, 2013 and July 31, 2017. Changes to the prophylaxis regimen were documented and analyzed. A total of 322 patients received TMP/SMX on two consecutive days per week for PJP prevention, of whom four had confirmed PJP (1.3%). Neutropenia was the most common reason for switching to alternative prophylaxis therapy (11.5%). Two consecutive prophylaxis days with TMP/SMX may be insufficient to prevent PJP in children with hematologic malignancies. Neutropenia remains a barrier for TMP/SMX use for PJP prophylaxis. Further studies to compare PJP incidence in children receiving alternative prophylaxis regimens should be considered.

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