{
  "abstract": "A man in his 80s with small cell lung cancer (SCLC) was admitted to hospital with suspected neutropaenic sepsis after a single cycle of chemotherapy. He failed to improve with broad-spectrum antibiotics and was noted to be lymphopaenic and recurrently hypokalaemic. Serum cortisol level was markedly elevated, suggesting SCLC-related paraneoplastic Ectopic Cushing’s Syndrome (ECS). Induced sputum revealed Pneumocystis jirovecii. Despite high-dose co-trimoxazole, he died from respiratory failure due to progressive multilobar pneumonia. We suggest that immunosuppression due to occult SCLC-related hypercortisolaemia resulted in death from P. jirovecii pneumoniae infection and that ECS should be considered as a cause of hypokalaemia and lymphopaenia in patients with SCLC.",
  "authors": [
    {
      "affiliations": [
        "County Durham and Darlington NHS Foundation Trust, Darlington, UK"
      ],
      "name": "Stephen Pennington"
    },
    {
      "affiliations": [
        "Respiratory Medicine, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK"
      ],
      "name": "Arun Brahmanya Prasad"
    },
    {
      "affiliations": [
        "County Durham and Darlington NHS Foundation Trust, Durham, UK"
      ],
      "name": "Stephen Murphy"
    }
  ],
  "title": "Pneumocystis jirovecii pneumonia infection in a patient with small cell lung cancer complicated by hypercortisolaemia and lymphopaenia",
  "uid": "63020118-76e2-5bcf-8d6c-dc1448b1b247"
}