{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T01:51:00Z","timestamp":1775872260133,"version":"3.50.1"},"reference-count":17,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,10]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>\n                    <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                    pneumonia (PJP) is a life-threatening opportunistic infection in immunocompromised patients. While classically seen in HIV\/AIDS, it is increasingly recognised in those receiving lymphodepleting chemotherapy and radiation. Early identification and treatment are critical. A man in his 60s with glioblastoma multiforme on adjuvant temozolomide and cranial radiation presented with a 10-day history of progressive dyspnoea. Home pulse oximetry fell to 70% on room air. CT chest showed bilateral ground-glass opacities. Induced sputum PCR was positive for\n                    <jats:italic>P. jirovecii<\/jats:italic>\n                    ; HIV serology was negative. He was started on high-dose intravenous trimethoprim\u2013sulfamethoxazole and a prednisone taper, with de-escalation of broad-spectrum antibiotics. By hospital day 7, he remained on high-flow nasal cannula at 25\u2009L\/min fraction of inspired oxygen (FiO\u2082) 60%, maintaining a peripheral capillary oxygen saturation (SpO\u2082) \u226592%. He was speaking in full sentences and ambulating without desaturation. This case highlights the need for vigilance for PJP in solid-tumour patients receiving temozolomide and radiation, and the importance of early diagnosis and therapy.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-268658","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T16:50:12Z","timestamp":1773679812000},"page":"e268658","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["<i>Pneumocystis jirovecii<\/i>\n                    pneumonia in a chemotherapy-induced immunocompromised patient with glioblastoma multiforme"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4066-1101","authenticated-orcid":false,"given":"Carson Price","family":"Cooper","sequence":"first","affiliation":[{"name":"School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4968-4206","authenticated-orcid":false,"given":"Lakshmi Sharath Chandran","family":"Thurikepally","sequence":"additional","affiliation":[{"name":"Osmania Medical College, Hyderabad, Telangana, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prescott","family":"Remington","sequence":"additional","affiliation":[{"name":"School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manthan Sanjay","family":"Shinde","sequence":"additional","affiliation":[{"name":"Tribhuvan University Institute of Medicine, Maharajganj, Lumbini Province, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chankokporn","family":"Puchongmart","sequence":"additional","affiliation":[{"name":"School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"2026031609500575000_19.3.e268658.1","unstructured":"Food and Drug A . Temodar (Temozolomide) capsules and injection: prescribing information \u2013 label revision (09\/14\/2023). Food and Drug Administration; 2023. Available: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2023\/021029s036_037_038lbl.pdf"},{"key":"2026031609500575000_19.3.e268658.2","unstructured":"National Cancer I . Common terminology criteria for adverse events (CTCAE) version 5.0. U.S. Department of Health and Human Services, National Institutes of Health; 2017."},{"key":"2026031609500575000_19.3.e268658.3","unstructured":"National Cancer I . Common terminology criteria for adverse events (CTCAE) version 6.0. U.S. Department of Health and Human Services, National Institutes of Health; 2024."},{"key":"2026031609500575000_19.3.e268658.4","doi-asserted-by":"crossref","unstructured":"Jia J , Beltran-Bless A , Alshamsan B , et al . 47 Pneumocystis jirovecii pneumonia prophylaxis in patients with glioma receiving concurrent chemoradiation: A systematic review. Neuro-Oncology Advances 2025;7. doi:10.1093\/noajnl\/vdaf166.044","DOI":"10.1093\/noajnl\/vdaf166.044"},{"key":"2026031609500575000_19.3.e268658.5","first-page":"815","article-title":"Post-Marketing Safety of Temozolomide: A Pharmacovigilance Study Based on the Food and Drug Administration Adverse Event Reporting System","volume":"103","author":"Lin","year":"2025","journal-title":"Oncology (Williston Park, NY)"},{"key":"2026031609500575000_19.3.e268658.6","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2334-11-224","article-title":"Diagnostic accuracy of procalcitonin in critically ill immunocompromised patients","volume":"11","author":"Bele","year":"2011","journal-title":"BMC Infect Dis"},{"key":"2026031609500575000_19.3.e268658.7","doi-asserted-by":"crossref","DOI":"10.3390\/pathogens10020237","article-title":"Pneumocystis jirovecii Pneumonia Prophylaxis for Cancer Patients during Chemotherapy","volume":"10","author":"Takeuchi","year":"2021","journal-title":"Pathogens"},{"key":"2026031609500575000_19.3.e268658.8","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.91a.23082"},{"key":"2026031609500575000_19.3.e268658.9","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s12281-024-00482-8","article-title":"Pneumocystis jirovecii Pneumonia in HIV-Negative, Non-transplant Patients: Epidemiology, Clinical Manifestations, Diagnosis, Treatment, and Prevention","volume":"18","author":"Rhoads","year":"2024","journal-title":"Curr Fungal Infect Rep"},{"key":"2026031609500575000_19.3.e268658.10","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-11-0774"},{"key":"2026031609500575000_19.3.e268658.11","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(93)90187-T"},{"key":"2026031609500575000_19.3.e268658.12","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1001\/jama.2023.9844","article-title":"Prophylaxis Against Pneumocystis jirovecii Pneumonia in Adults","volume":"330","author":"Zhou","year":"2023","journal-title":"JAMA"},{"key":"2026031609500575000_19.3.e268658.13","article-title":"Clinical Characteristics and Outcomes of Pneumocystis jirovecii Pneumonia in Cancer Patients From a Tertiary Care Hospital","volume":"15","author":"Shehbaz","year":"2023","journal-title":"Cureus"},{"key":"2026031609500575000_19.3.e268658.14","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1093\/cid\/ciae239","article-title":"Polymerase Chain Reaction on Respiratory Tract Specimens of Immunocompromised Patients to Diagnose Pneumocystis Pneumonia: A Systematic Review and Meta-analysis","volume":"79","author":"Brown","year":"2024","journal-title":"Clin Infect Dis"},{"key":"2026031609500575000_19.3.e268658.15","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/S2213-2600(25)00125-0","article-title":"Adjunctive corticosteroids in non-AIDS patients with severe Pneumocystis jirovecii pneumonia (PIC): a multicentre, double-blind, randomised controlled trial","volume":"13","author":"Lemiale","year":"2025","journal-title":"Lancet Respir Med"},{"key":"2026031609500575000_19.3.e268658.16","first-page":"321","article-title":"Pneumocystis jirovecii prophylaxis in patients treated for high-grade gliomas: a survey among neuro-oncologists","volume":"6","author":"Skorupan","year":"2019","journal-title":"Neurooncol Pract"},{"key":"2026031609500575000_19.3.e268658.17","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1093\/neuonc\/noac072","article-title":"Effectiveness and safety of pneumocystis pneumonia prophylaxis for patients receiving temozolomide chemoradiotherapy","volume":"24","author":"Climans","year":"2022","journal-title":"Neuro Oncol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268658","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T16:50:16Z","timestamp":1773679816000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268658"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":17,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,16]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bcr-2025-268658"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268658","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}