Pneumocystis carinii pneumonia in patients with primary brain tumors
J. W. Henson, J. K. Jalaj, R. W. Walker, D. E. Stover and A. O. Fels
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
All histologically documented episodes of Pneumocystis carinii pneumonia in
adult patients with primary brain tumors treated at Memorial
Sloan-Kettering Cancer Center, New York, NY, since 1981, were
retrospectively reviewed. Pneumocystis carinii pneumonia was histologically
documented 11 times in 10 patients. During the same 8-year interval,
approximately 587 adults were seen at the center for a brain tumor, 90% of
whom received ongoing therapy. Therefore, in at least 1.7% (10/587) of our
patients with brain tumors, P carinii pneumonia developed. The median
duration of dexamethasone therapy at the onset of P carinii pneumonia
symptoms was 2.75 months. Symptoms began during tapering of steroid therapy
in eight episodes. Bronchoscopy was diagnostic in the eight cases in which
it was performed. Four episodes (40%) were fatal.
Trimethoprim-sulfamethoxazole prophylaxis may be indicated in some patients
with brain tumors, especially during tapering of steroid therapy.
