Not COVID-19, Don't Overlook Pneumocystis in Patients on Gefitinib!

Curr Oncol. 2021 Feb 21;28(1):961-964. doi: 10.3390/curroncol28010094.


An 82-year-old woman treated for advanced lung cancer with gefitinb was admitted to the emergency unit complaining of dyspnea. Chest computed tomography found abnormalities classified as possible diffuse COVID-19 pneumonia. RT-PCR for Sars-Cov-2 was twice negative. PCR for Pneumocystis jirovecii was positive on bronchoalveolar lavage. The final diagnosis was Pneumocystis jirovecii pneumonia. Therefore, physicians must be careful not to misdiagnose COVID-19, especially in cancer patients on small-molecule therapeutics like gefitinib and corticosteroids.

Keywords: COVID-19; gefitinib; pneumocystis jirovecii; tyrosine-kinase inhibitor.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • COVID-19 / diagnosis
  • COVID-19 / virology
  • Diagnostic Errors
  • Female
  • Gefitinib / adverse effects
  • Gefitinib / therapeutic use*
  • Humans
  • Lung Neoplasms / drug therapy*
  • Pneumocystis carinii / genetics
  • Pneumonia, Pneumocystis / diagnosis*
  • Pneumonia, Pneumocystis / drug therapy
  • SARS-CoV-2 / genetics
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use


  • Antineoplastic Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Gefitinib