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KMID : 0882420120830050679
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Korean Journal of Medicine
2012 Volume.83 No. 5 p.679 ~ p.682
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Hypoglycemic Seizures Associated with Pentamidine for Pneumocystis jiroveci Pneumonia in a HIV Patient
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Choi Hong-Seok
Ki Hyun-Kyun
Song Kee-Ho
Cheong Hae-Suk
Seo Jung-Woong
Jung Hyun-A
Hwang Yong
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Abstract
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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.
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KEYWORD
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Pentamidine, Hypoglycemia, Pneumocystis jiroveci
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