Reactions 1431 - 8 Dec 2012

SAntineoplastics

Immunosuppression leading to septic arthritis:case report

A 64-year-old woman with non-Hodgkin’s lymphoma(NHL) developed septic arthritis, after experiencingimmunosuppression after chemotherapy with cytarabine,bleomycin, vincristine and methotrexate.

The woman was admitted for NHL staging with fever andasthenia. After prior NHL diagnosis in January 2010, shehad received cytarabine [Aracytin], bleomycin, vincristineand methotrexate [routes, dosages and time to reactiononset not stated]. Chemotherapy had been withdrawn atthe second cycle due to decreased white blood cell andhaemoglobin levels. At examination, she had pain onpressure over her left hip, with functional impotence andimmobilisation in an antalgic position. Her symptoms,taken together with fludeoxyglucose F18-PET/CT scanresults, led to suspicion of a septic process in her left hip.Her haemoglobin and white blood cell levels were belowthe normal ranges, and she had an elevated erythrocytesedimentation rate and C-reactive protein level. MRIsuggested septic arthritis, and blood cultures revealedEscherichia coli.

The woman received ciprofloxacin; her fever and hippain resolved, and after 21 days of treatment herinflammatory indexes normalised.

Author comment: The authors report a woman "whoshowed immunosuppression after chemotherapy, joint painat the left hip joint, that will result [in] a septic arthritis."Niccoli Asabella A, et al. Different causes of 18-Fluorine-labelled-2-deoxy-2-fluoro-D-glucose uptake in a patient with non-Hodgkinlymphoma. Gazzetta Medica Italiana Archivio per le Scienze Mediche 171:351-356, No. 3, Jun 2012 - Italy 803080950

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Reactions 8 Dec 2012 No. 14310114-9954/10/1431-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved