Two Patients with Gastric Cancer Recovering from Postoperative Viral Pneumonia due to Cyotomegarovirus

Kiyokazu Hiwatashi, Sumiya Ishigami, Hironori Sakita, Shuichi Hokita, Shoji Natsugoe and Takashi Aikou

First Department of Surgery, Kagoshima University School of Medicine

We encountered two patients with gastric cancer who suffered from postoperative CMV pneumonia. Case 1: A 63-year-old man, who received intra-abdominal CDDP administration before gastrectomy. On the 10th postoperative day, interstitial pneumonia was diagnosed. He was suspected as having CMV pneumonia and antiviral drugs were administered. He needed ECMO due to severe pulmonary insufficiency. A definitive diagnosis was established 10 days after the commencement of drug administration. He eventually recovered from the pneumonia. Case 2: A 66-year-old man with early gastric cancer underwent distal gastrectomy. He had received postoperative radiation therapy for the treatment of lung cancer. Postoperatively, interstitial pneumonia was diagnosed. He was also suspected as having CMV pneumonia and antiviral drugs were administrated empirically. The postoperative lymphocyte counts in both patients showed immunosuppression associated with radiation or chemotherapy may predispose to postoperative viral pneumonia. CMV pneumonia is a critical condition and early administration of antiviral agents is necessary even before a definite diagnosis can be made. Postoperative CMV pneumonia in patients with gastric cancer is rare. We should however be aware of the risk of its development and promptly administer antiviral drugs should it occur.

Key words
cytomegalovirus, gastric cancer, pneumonia

Reprint requests
Kiyokazu Hiwatashi First Department of Surgery, Kagoshima University School of Medicine 8-35-1 Sakuragaoka, Kagoshima, 890-8520 JAPAN

Accepted
July 25, 2000

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