{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T15:37:52Z","timestamp":1776440272790,"version":"3.51.2"},"reference-count":0,"publisher":"Harborside Press, LLC","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JADPRO"],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:p>Mr. B is a 56-year-old man diagnosed with metastatic HER2-positive gastroesophageal adenocarcinoma. He received front-line leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX) and trastuzumab for 10 months before restaging imaging revealed progressive disease. He then received second-line trastuzumab deruxtecan. His treatment was complicated by several admissions felt to be unrelated to his cancer therapy. He was discharged after an episode of pneumonia on a steroid taper with prophylactic trimethoprim\/sulfamethoxazole. Once he recovered, he was given a fourth dose of chemotherapy. About a week later, wheezes were noticed on physical exam, and he was given a 5-day course of levofloxacin. Around the same time, he also finished his steroid taper. Twelve days after his dose of chemotherapy, he presented to the emergency room with 3 to 4 days of progressive shortness of breath and dry cough following the completion of levofloxacin without symptom improvement. A CT scan showed increasing airspace opacities and multifocal areas of consolidation. Blood, nasal, and sputum cultures were negative. A bronchoscopy was performed that did not reveal findings concerning for capillaritis. He was ultimately diagnosed with drug-induced pneumonitis\/interstitial lung disease (ILD). Mr. B continued to experience worsening hypoxic respiratory failure despite continuous IV steroids. He was discharged to an inpatient hospice facility where he passed away 2 weeks later. Drug-induced pneumonitis\/ILD should be considered in all patients receiving trastuzumab deruxtecan who develop progressive shortness of breath or other respiratory complaints.<\/jats:p>","DOI":"10.6004\/jadpro.2023.14.5.8","type":"journal-article","created":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T20:13:47Z","timestamp":1690402427000},"page":"440-443","source":"Crossref","is-referenced-by-count":1,"title":["Can You Establish the Cause of This Patient\u2019s Shortness of Breath?"],"prefix":"10.6004","volume":"14","author":[{"given":"Allison","family":"Trail, PA-C","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Rogers, PharmD, BCOP","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaffer","family":"Ajani, MD","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4047","published-online":{"date-parts":[[2023,7,1]]},"container-title":["Journal of the Advanced Practitioner in Oncology"],"original-title":[],"deposited":{"date-parts":[[2023,7,26]],"date-time":"2023-07-26T20:15:22Z","timestamp":1690402522000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.advancedpractitioner.com\/issues\/volume-14,-number-5-(julaug-2023)\/can-you-establish-the-cause-of-this-patient%E2%80%99s-shortness-of-breath.aspx"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":0,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,7,1]]},"published-print":{"date-parts":[[2023,7,1]]}},"URL":"https:\/\/doi.org\/10.6004\/jadpro.2023.14.5.8","relation":{},"ISSN":["2150-0878"],"issn-type":[{"value":"2150-0878","type":"print"}],"subject":[],"published":{"date-parts":[[2023,7,1]]}}}