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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. |
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