Reactions weekly: Multiple drugs
Abstract
Drug-induced pneumonia, Legionella pneumophila pneumonia and lack of efficacy: case report A 57-year-old man developed drug-induced pneumonia during treatment with pembrolizumab and pemetrexed for metastatic adenocarcinoma at the right upper lung lobe. Subsequently, he developed Legionella pneumophila pneumonia during treatment with dexamethasone and prednisolone for drug-induced pneumonia, and exhibited lack of efficacy during treatment with levofloxacin for Legionella pneumophila pneumonia [not all dosage stated, routes and durations of treatments to reaction onsets not stated]. The man was admitted to the hospital in Japan with dyspnoea and fever, which occurred on the morning of the day of admission. He had a history of drinking 2U of alcohol per day and was a smoker. He was diagnosed with metastatic adenocarcinoma at the right upper lung lobe (cT4N3M1c Stage IV B) 5 months previously. Thereafter, he received first-line chemotherapy with pembrolizumab and pemetrexed. However, he developed drug-induced pneumonia due to pembrolizumab and pemetrexed during the first cycle of chemotherapy. Therefore, the man was treated with prednisolone 60 mg/day, which was then then tapered off. Thereafter, he had started receiving dexamethasone. At the time of current presentation, he had received corticosteroid therapy for 4 months and had been receiving dexamethasone 2 mg/day. One month prior to the admission, he had received two cycles of carboplatin and paclitaxel [nab-paclitaxel] as…
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