Journal article
Listeria brain abscess, Pneumocystis pneumonia and Kaposi's sarcoma after temozolomide.
- Ganière V University of Lausanne Hospitals, Lausanne, Switzerland.
- Christen G
- Bally F
- Guillou L
- Pica A
- de Ribaupierre S
- Stupp R
- 2006-06-08
Published in:
- Nature clinical practice. Oncology. - 2006
Antineoplastic Agents, Alkylating
Brain Abscess
Brain Neoplasms
Dacarbazine
Glioblastoma
Humans
Listeriosis
Male
Middle Aged
Neoadjuvant Therapy
Pneumocystis carinii
Pneumonia, Pneumocystis
Sarcoma, Kaposi
Temozolomide
English
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.
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.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1038/ncponc0514
- PMID 16757971
- Persistent URL
- https://sonar.ch/global/documents/289562
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