A Case Report of Pneumocystis Jiroveci Pneumonia in a Patient with Metastatic Breast Cancer

Abstract

We describe a 69-year-old woman with metastatic breast cancer who developed dyspnea on exertion, persistent cough, fever and fatigue while on everolimus and exemestane combination. The initial differentials included opportunistic infection such as pneumocystis jiroveci pneumonia (PJP) vs. pneumonitis. Bronchoalveolar lavage (BAL) from bronchoscopy revealed PJP. The patient recovered after appropriate treatment. We also correlated the progressive decrease in her absolute lymphocyte count with PJP infection and recovery. This is the second case that PJP has been described in patients with breast cancer receiving everolimus. Clinicians should be vigilant in their monitoring of patients on everolimus-based regimens and promptly institute appropriate therapy to reduce and prevent morbidity and mortality.