Open AccessBleomycin lung: a case report
Author(s) -
Rabia Sofia Rashid
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.11.2008.1175
Subject(s) - medicine , bleomycin , lethargy , pulmonary fibrosis , lung , idiopathic pulmonary fibrosis , respiratory failure , intensive care unit , interstitial lung disease , emergency department , pulmonary toxicity , chemotherapy , respiratory disease , radiology , surgery , psychiatry
A 69-year-old gentleman with non-Hodgkin's lymphoma (stage I), with baseline fibrotic lung changes on CT, received six cycles of R-PMitCebo chemotherapy containing bleomycin. Three months later he presented to the Accident and Emergency Department with progressive dyspnoea, dry cough, pyrexia and generalised lethargy. Chest radiographs showed bilateral lower zone opacities. Clinically, all signs initially pointed to community-acquired penumonia, but he failed to respond to standard treatment for this. Repeat high-resolution CT (HRCT) subsequently showed widespread peripheral interstitial changes consistent with marked fibrotic lung changes. It became apparent that this was in fact bleomycin-induced pulmonary toxicity. The patient rapidly deteriorated and developed type I respiratory failure. Despite intensive steroid treatment, the patient progressively got worse and died in the Intensive Therapy Unit 10 days after admission. Death was directly attributed to pulmonary fibrosis secondary to bleomycin treatment.