Antineoplastics
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Reactions 1431 - 8 Dec 2012 S Antineoplastics Cryptococcal osteomyelitis and cryptococcal meningitis in an elderly patient: case report A 66-year-old man developed cryptococcal osteomyelitis and cryptococcal meningitis while receiving the PEP-C regimen, consisting of prednisone, etoposide, procarbazine and cyclophosphamide. The man had been diagnosed with B-cell lymphoma. After a partial response following first-line therapy, he started receiving daily oral chemotherapy with the PEP-C regimen: prednisone 20mg, etoposide 50mg, procarbazine 50mg and cyclophosphamide 50mg. Three months later, he developed rightsided rib pain. The pain increased over the following months and was accompanied by a low-grade fever and headache. Laboratory investigations showed low total and absolute leucocyte counts. PEP-C was discontinued. MRI of his thorax showed a lesion involving his eighth right rib and subcutaneous tissue, and a lesion in the posterior aspect of the L3 vertebral body. Fungal culture of biopsied rib tissue was positive for a single colony of Cyptococcus neoformans. Serum cryptococcal antigen titre was elevated. He was diagnosed with cryptococcal osteomyelitis. Central nervous system involvement was considered a possibility; MRI and CSF studies indicated cryptococcal meningitis. The man received amphotericin B [AmBisome], but he developed renal insufficiency; his treatment was switched to fluconazole. After 12 months of treatment, his cryptococcal infections completely resolved. Author comment: "To our knowledge, our case provides a first report of a patient with lymphoma who developed concurrent cryptococcal osteomyelitis and cryptococcal meningitis while being treated with the Pep-C regimen." To CA, et al. Cryptococcal osteomyelitis and meningitis in a patient with non- hodgkin’s lymphoma treated with PEP-C. BMJ Case Reports : Sep 2012. Available from: URL: http://dx.doi.org/10.1136/bcr.08.2011.4578 - USA 803080758 1 Reactions 8 Dec 2012 No. 1431 0114-9954/10/1431-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
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Transcript of Antineoplastics
Reactions 1431 - 8 Dec 2012
SAntineoplastics
Cryptococcal osteomyelitis and cryptococcalmeningitis in an elderly patient: case report
A 66-year-old man developed cryptococcal osteomyelitisand cryptococcal meningitis while receiving the PEP-Cregimen, consisting of prednisone, etoposide,procarbazine and cyclophosphamide.
The man had been diagnosed with B-cell lymphoma.After a partial response following first-line therapy, hestarted receiving daily oral chemotherapy with the PEP-Cregimen: prednisone 20mg, etoposide 50mg, procarbazine50mg and cyclophosphamide 50mg. Three months later,he developed rightsided rib pain. The pain increased overthe following months and was accompanied by a low-gradefever and headache. Laboratory investigations showed lowtotal and absolute leucocyte counts.
PEP-C was discontinued. MRI of his thorax showed alesion involving his eighth right rib and subcutaneoustissue, and a lesion in the posterior aspect of the L3vertebral body. Fungal culture of biopsied rib tissue waspositive for a single colony of Cyptococcus neoformans.Serum cryptococcal antigen titre was elevated. He wasdiagnosed with cryptococcal osteomyelitis. Centralnervous system involvement was considered a possibility;MRI and CSF studies indicated cryptococcal meningitis.The man received amphotericin B [AmBisome], but hedeveloped renal insufficiency; his treatment was switchedto fluconazole. After 12 months of treatment, hiscryptococcal infections completely resolved.
Author comment: "To our knowledge, our case provides afirst report of a patient with lymphoma who developedconcurrent cryptococcal osteomyelitis and cryptococcalmeningitis while being treated with the Pep-C regimen."To CA, et al. Cryptococcal osteomyelitis and meningitis in a patient with non-hodgkin’s lymphoma treated with PEP-C. BMJ Case Reports : Sep 2012. Availablefrom: URL: http://dx.doi.org/10.1136/bcr.08.2011.4578 - USA 803080758
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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
