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Unexpected Fatal Pneumocystis Jirovecii Pneumonia During Triplet Therapy for Hormone‐Sensitive Prostate Cancer

Year: 2025

Type: article

Abstract: Pneumocystis jirovecii pneumonia (PJP) is a life-threatening opportunistic infection typically seen in immunocompromised patients. It is rarely reported during standard systemic therapy for prostate cancer. A 75-year-old man with low-volume metastatic hormone-sensitive prostate cancer (mHSPC) received triplet therapy with relugolix, darolutamide and docetaxel. He had well-controlled diabetes and no history of immunosuppression. After the second docetaxel cycle, he developed anorexia. Chest CT revealed bilateral ground-glass opacities. β-D-glucan was elevated, and sputum PCR detected P. jirovecii DNA. Despite appropriate trimethoprim-sulfamethoxazole and corticosteroid therapy, he died of respiratory failure ~10 days after symptom onset. This case highlights an underrecognized risk of PJP during triplet therapy for mHSPC. Prophylaxis should be considered in select high-risk patients, including elderly individuals or those with metabolic comorbidities.

Source: Respirology Case Reports

DOI: 10.1002/rcr2.70435

Authors: Fumihiro Ito, Koki Kobayashi, Gaku Hayashi, Shunsuke Kamijo, Takashi Fujita

Institution: Gifu Prefectural Tajimi Hospital

Language: English

Topic: Pneumocystis jirovecii pneumonia detection and treatment

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,130