Antineoplastics
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Reactions 1413 - 4 Aug 2012 S Antineoplastics Febrile neutropenia leading to ecthyma gangrenosum: case report A 41-year-old man with B-cell lymphoma developed ecthyma gangrenosum secondary to chemotherapy- induced febrile neutropenia [routes, dosages and outcomes not stated]. The man was hospitalised with febrile neutropenia while receiving chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab. He was successfully treated with metronidazole and piperacillin/ tazobactam. Twelve days after completing his sixth cycle of chemotherapy, he presented to the emergency department with a 3-week history of erythematous skin lesions on his trunk, arms and legs, accompanied by a 2-day history of malaise, fever and diarrhoea. Despite initial treatment with clindamycin, his skin lesions had not improved. Upon admission, he had a temperature of 40°C, BP of 90/50mm Hg, HR of 120 beats/min and a respiratory rate of 32 breaths/min. Laboratory investigations included the following: leukocyte count 1.0 × 10 3 cells/mm 3 , absolute neutrophil count 0.7 × 10 3 cells/mm 3 , platelet count 63 × 10 3 cells/mm 3 , haemoglobin 6.9 g/dL and creatinine 4.4 mg/dL. A large lesion on his right thigh was consistent with ecthyma gangrenosum, and a bacterial infection was suspected. Blood and skin cultures yielded Pseudomonas aeruginosa. The man was treated with ciprofloxacin and piperacillin/ tazobactam. He subsequently underwent debridement of several necrotic skin lesions, followed by skin grafting to the abdomen, right arm and right thigh. Author comment: "[I]n patients receiving chemotherapy, mucosal injury and neutropenia may result in bacteremia with secondary hematogenous seeding of the skin." Moayedi Y, et al. From the outside looking in. American Journal of Medicine 125: 457-60, No. 5, May 2012 - Canada 803074814 1 Reactions 4 Aug 2012 No. 1413 0114-9954/10/1413-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1413 - 4 Aug 2012
SAntineoplastics
Febrile neutropenia leading to ecthymagangrenosum: case report
A 41-year-old man with B-cell lymphoma developedecthyma gangrenosum secondary to chemotherapy-induced febrile neutropenia [routes, dosages and outcomesnot stated].
The man was hospitalised with febrile neutropenia whilereceiving chemotherapy with cyclophosphamide,doxorubicin, vincristine, prednisone and rituximab. He wassuccessfully treated with metronidazole and piperacillin/tazobactam. Twelve days after completing his sixth cycle ofchemotherapy, he presented to the emergency departmentwith a 3-week history of erythematous skin lesions on histrunk, arms and legs, accompanied by a 2-day history ofmalaise, fever and diarrhoea. Despite initial treatment withclindamycin, his skin lesions had not improved. Uponadmission, he had a temperature of 40°C, BP of90/50mm Hg, HR of 120 beats/min and a respiratory rate of32 breaths/min. Laboratory investigations included thefollowing: leukocyte count 1.0 × 103 cells/mm3, absoluteneutrophil count 0.7 × 103 cells/mm3, platelet count63 × 103 cells/mm3, haemoglobin 6.9 g/dL and creatinine4.4 mg/dL. A large lesion on his right thigh was consistentwith ecthyma gangrenosum, and a bacterial infection wassuspected. Blood and skin cultures yielded Pseudomonasaeruginosa.
The man was treated with ciprofloxacin and piperacillin/tazobactam. He subsequently underwent debridement ofseveral necrotic skin lesions, followed by skin grafting tothe abdomen, right arm and right thigh.
Author comment: "[I]n patients receiving chemotherapy,mucosal injury and neutropenia may result in bacteremiawith secondary hematogenous seeding of the skin."Moayedi Y, et al. From the outside looking in. American Journal of Medicine 125:457-60, No. 5, May 2012 - Canada 803074814
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Reactions 4 Aug 2012 No. 14130114-9954/10/1413-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
