Not COVID-19, Don't Overlook Pneumocystis in Patients on Gefitinib!

An 82-year-old woman treated for advanced lung cancer with gefitinb was admitted to the emergency unit complaining of dyspnea. Chest computed tomography found abnormalities classified as possible diffuse COVID-19 pneumonia. RT-PCR for Sars-Cov-2 was twice negative. PCR for Pneumocystis jirovecii was positive on bronchoalveolar lavage. The final diagnosis was Pneumocystis jirovecii pneumonia. Therefore, physicians must be careful not to misdiagnose COVID-19, especially in cancer patients on small-molecule therapeutics like gefitinib and corticosteroids.

Automated summary

An 82-year-old woman with advanced lung cancer treated with gefitinib was admitted to the emergency unit for dyspnea. Despite initial suspicion of COVID-19 pneumonia based on chest CT findings, the final diagnosis was Pneumocystis jirovecii pneumonia confirmed by PCR. Physicians need to be cautious to avoid misdiagnosing COVID-19 in cancer patients on small-molecule therapy like gefitinib and corticosteroids.