Hypoglycemic Seizures Associated with Pentamidine for Pneumocystis jiroveci Pneumonia in a HIV Patient.
- Author:
Hong Seok CHOI
1
;
Hyun Kyun KI
;
Kee Ho SONG
;
Hae Suk CHEONG
;
Jung Woong SEO
;
Hyun Ah CHUNG
;
Yong HWANG
Author Information
1. Department of Internal Medicine, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea. kihkdr@kuh.ac.kr
- Publication Type:Case Report
- Keywords:
Pentamidine;
Hypoglycemia;
Pneumocystis jiroveci
- MeSH:
Coma;
Diabetes Mellitus;
Epilepsy;
Glucose;
HIV;
Humans;
Hypoglycemia;
Korea;
Neurologic Manifestations;
Pentamidine;
Pneumocystis;
Pneumocystis jirovecii;
Pneumonia;
Seizures;
Stroke;
Treatment Failure;
Trimethoprim, Sulfamethoxazole Drug Combination
- From:Korean Journal of Medicine
2012;83(5):679-682
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Trimethoprim-sulfamethoxazole (TMX-SMZ) is the initial treatment for Pneumocystis jiroveci pneumonia in human immunodeficiency virus (HIV) patients. About 20% of patients do not complete the TMX-SMZ treatment due to treatment failure or adverse reactions. Pentamidine isethionate has been used for P. jiroveci pneumonia as a second-line regimen. Although hypoglycemia is a common adverse effect of pentamidine, pentamidine-induced hypoglycemia has not been reported in Korea. We present an HIV patient with grand mal seizures caused by pentamidine-induced hypoglycemia who was managed successfully with IV dextrose infusion. Mental changes can occur during pentamidine treatment, but hypoglycemia is often ignored and misdiagnosed as epilepsy or stroke. It can result in seizures, coma, and even death. We should be aware of pentamidine-induced hypoglycemia, which can lead to severe neurologic deficits and diabetes mellitus.
