24th February 2025

A 56-year-old patient with metastatic lung adenocarcinoma receives their first cycle of treatment

A 56-year-old patient with metastatic lung adenocarcinoma receives their first cycle of treatment with combination immunotherapy and chemotherapy with pembrolizumab, pemetrexed and carboplatin. She presents 9 days later with a cough productive of green sputum and sweating.

Observations reveal: HR 118 bpm, BP 95/67 mmHg, RR 18 breaths/minute, oxygen saturation 91% on room air and a temperature of 38.5 degrees Celsius.

Intravenous fluids and oxygen therapy via nasal cannulae are started. A plain chest radiograph is performed in A&E that shows right lower zone airspace opacification and air bronchograms. Her blood results are pending.

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