Antineoplastics
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Reactions 1388 - 11 Feb 2012 S Antineoplastics Enterococcus faecium sepsis in an elderly patient: case report A 65-year-old woman developed Enterococcus faecium sepsis during chemotherapy for acute myeloid leukaemia [dosages, routes and duration of treatments to reaction onsets not stated]. The woman started receiving chemotherapy with cytarabine, idarubicin and tretinoin (all-trans retinoic acid; ATRA) according to the AML SG-06/04 protocol, with prophylactic levofloxacin. She developed low-grade fever on therapy day 9, the central venous catheter was removed and piperacillin/tazobactam was added to her antibiotic regimen. On therapy day 14, re-induction according to the GO-A-HAM protocol was started due to persistent myeloblasts; the protocol included gemtuzumab- ozogamicin, cytarabine, mitoxantrone and tretinoin. On day 11 of the new protocol, she developed high-grade fever of up to 39.5°C. Her CRP level was elevated at 1.36 mg/dL, and urine samples were taken. The woman’s antibiotic therapy was changed from piperacillin/tazobactam to vancomycin and meropenem for 16 days. Blood and urine cultures grew E. faecium, and both a normal phenotype and a small-colony variant were identified in the blood culture. A chest CT scan revealed bacterial infiltrates on day 14. However, no pathogens were isolated from bronchoalveolar lavage fluid 2 days later. Amphotericin B liposomal and aciclovir were added to her therapy on day 18. Her fever resolved on day 35, and she was discharged home on day 61. Grobner S, et al. Characterization of an Enterococcus faecium small-colony variant isolated from blood culture. International Journal of Medical Microbiology 302: 40-44, No. 1, Jan 2012. Available from: URL: http://dx.doi.org/10.1016/ j.ijmm.2011.07.001 - Germany 803066722 1 Reactions 11 Feb 2012 No. 1388 0114-9954/10/1388-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1388 - 11 Feb 2012
SAntineoplastics
Enterococcus faecium sepsis in an elderlypatient: case report
A 65-year-old woman developed Enterococcus faeciumsepsis during chemotherapy for acute myeloid leukaemia[dosages, routes and duration of treatments to reactiononsets not stated].
The woman started receiving chemotherapy withcytarabine, idarubicin and tretinoin (all-trans retinoic acid;ATRA) according to the AML SG-06/04 protocol, withprophylactic levofloxacin. She developed low-grade feveron therapy day 9, the central venous catheter was removedand piperacillin/tazobactam was added to her antibioticregimen. On therapy day 14, re-induction according to theGO-A-HAM protocol was started due to persistentmyeloblasts; the protocol included gemtuzumab-ozogamicin, cytarabine, mitoxantrone and tretinoin. Onday 11 of the new protocol, she developed high-grade feverof up to 39.5°C. Her CRP level was elevated at 1.36 mg/dL,and urine samples were taken.
The woman’s antibiotic therapy was changed frompiperacillin/tazobactam to vancomycin and meropenem for16 days. Blood and urine cultures grew E. faecium, andboth a normal phenotype and a small-colony variant wereidentified in the blood culture. A chest CT scan revealedbacterial infiltrates on day 14. However, no pathogens wereisolated from bronchoalveolar lavage fluid 2 days later.Amphotericin B liposomal and aciclovir were added to hertherapy on day 18. Her fever resolved on day 35, and shewas discharged home on day 61.Grobner S, et al. Characterization of an Enterococcus faecium small-colony variantisolated from blood culture. International Journal of Medical Microbiology 302:40-44, No. 1, Jan 2012. Available from: URL: http://dx.doi.org/10.1016/j.ijmm.2011.07.001 - Germany 803066722
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Reactions 11 Feb 2012 No. 13880114-9954/10/1388-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
