A case of pulmonary tuberculosis developed during chemotherapy for local advanced colon cancer

  • HYAKUDOMI Ryoji
    Department of Digestive and General Surgery, Shimane University Faculty of Medicine
  • YAMAMOTO Tetsu
    Department of Digestive and General Surgery, Shimane University Faculty of Medicine
  • ISHITOBI Kazunari
    Department of Digestive and General Surgery, Shimane University Faculty of Medicine
  • TANIURA Takahito
    Department of Digestive and General Surgery, Shimane University Faculty of Medicine
  • ZOTANI Hitomi
    Department of Digestive and General Surgery, Shimane University Faculty of Medicine
  • TAKAI Kiyoe
    Department of Digestive and General Surgery, Shimane University Faculty of Medicine
  • HIRAHARA Noriyuki
    Department of Digestive and General Surgery, Shimane University Faculty of Medicine
  • TAJIMA Yoshitsugu
    Department of Digestive and General Surgery, Shimane University Faculty of Medicine

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Other Title
  • 局所進行結腸癌に対する化学療法中に肺結核を発症した1例

Abstract

<p>We report a case of pulmonary tuberculosis developed during chemotherapy for colon cancer. A 78-year-old man with dyspnea was referred to our hospital for the treatment of transverse colon cancer with duodenal invasion. Chemotherapy was initiated for severe respiratory dysfunction associated with emphysema. After 3 months of chemotherapy, the patient required hospitalization because of severe general fatigue and appetite loss. Pneumonia occurred on the 9th hospital day. Antibiotic therapies with cefotiam hydrochloride or tazobactam/piperacillin were ineffective, his respiratory condition gradually decreased, and thus, endotracheal intubation was required. The patient was finally diagnosed with pulmonary tuberculosis by acid-fast staining of the sputum. Antituberculosis therapy with rifampicin, isoniazid, and streptomycin was effective, and acid-fast staining became negative after 2 weeks of antituberculosis therapy. However, he could not withdraw from the ventilator support and died of cancer progression on the 94th hospital day. Because chemotherapies induce immunosuppression, a targeted screening for latent tuberculosis infection should be performed in patients with colorectal cancer who are highly at risk for tuberculosis before starting chemotherapy, and pulmonary tuberculosis should be ruled out when a patient develops symptoms of pneumonia during chemotherapy.</p>

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