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October 1992

Pneumocystis carinii Pneumonia Associated With Solid Ectopic Corticotropin-Producing Tumors

Author Affiliations

Maxwell Finland Laboratory for Infectious Diseases Department of Medicine Boston City Hospital Boston University School of Medicine Boston, MA 02118
Section of Infectious Diseases Department of Medicine The University Hospital Boston University School of Medicine Boston, MA 02118

Arch Neurol. 1992;49(10):1012. doi:10.1001/archneur.1992.00530340028012

To the Editor.  —We read with interest the review of cases of Pneumocystis carinii pneumonia (PCP) occurring in patients with primary brain tumors who were treated with long-term dexamethasone therapy.1 In their discussion, Henson et al1 note the well-documented association of PCP with the use of high-dose corticosteroids and the appearance of clinical pneumonia as steroid doses are tapered. The authors state that reports of PCP among patients with solid tumors are rare and suggest that PCP may occur in a subset of patients with solid tumors, namely, those with brain tumors. They conclude that PCP in these patients is due to the use of high-dose corticosteroids.It is important to note that patients with solid ectopic corticotropin-producing tumors are also at risk for the development of PCP (and other opportunistic infections). Graham and Tucker2 reviewed 23 cases of opportunistic infections (cryptococcosis, aspergillosis, nocardiosis, and PCP) in

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