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
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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