Listeria brain abscess, Pneumocystis pneumonia and Kaposi's sarcoma after temozolomide.
Autor: | Ganière V; University of Lausanne Hospitals, Lausanne, Switzerland., Christen G, Bally F, Guillou L, Pica A, de Ribaupierre S, Stupp R |
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Jazyk: | angličtina |
Zdroj: | Nature clinical practice. Oncology [Nat Clin Pract Oncol] 2006 Jun; Vol. 3 (6), pp. 339-43; quiz following 343. |
DOI: | 10.1038/ncponc0514 |
Abstrakt: | Background: A 55-year-old man with glioblastoma multiforme was treated with continuous, dose-dense temozolomide. This therapy was curtailed after three cycles because of nausea, asthenia, and neuropsychological deterioration. During a subsequent course of radiotherapy, the patient developed fever, headaches, and cutaneous lesions. Investigations: Physical examination, cerebral MRI, brain biopsy, skin biopsy, immunohistochemistry, bronchoscopy with bronchoalveolar lavage, and laboratory tests. Diagnosis: Severe temozolomide-induced immunosuppression, exacerbated by corticosteroids, with profound T-cell lymphocytopenia and simultaneous opportunistic infections with Pneumocystis jiroveci pneumonia, brain abscess with Listeria monocytogenes, and cutaneous Kaposi's sarcoma. Management: Discontinuation of temozolomide, discontinuation of radiotherapy, antibiotic treatment with amoxicillin and gentamicin, and administration of atovaquone and pentamidine. |
Databáze: | MEDLINE |
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