cefotaxime and Lymphoma--B-Cell

A 59-year-old female patient with a history of malignant lymphoma presented with symptoms of septicaemia. The skin of the extremities showed bullous, necrotizing plaques. Blood culture revealed Vibrio vulnificus as the causative organism. The infection was most likely acquired while swimming in the unusually warm Baltic Sea through inadvertent swallowing of sea water. The disease is rare in Europe. It is discussed in view of its typical clinical and histological picture.

Topics: Anti-Bacterial Agents; Cefotaxime; Female; Humans; Injections, Intravenous; Lymphoma, B-Cell; Middle Aged; Remission Induction; Sepsis; Skin; Sweet Syndrome; Swimming; Time Factors; Treatment Outcome; Vibrio Infections; Vibrio vulnificus

We report two patients with low-grade malignant primary cutaneous B cell lymphoma in association with Borrelia burgdorferi infection. Extracutaneous manifestations were ruled out by standard staging procedures. Infection with Borrelia burgdorferi was confirmed by cultivation from lesional skin in both patients. In the first patient skin lesions cleared completely after pulse therapy with cefotaxime, whereas in the second patient antibiotic treatment failed. In this patient, however, skin lesions completely cleared after intralesional injection of interferon alfa-2a. Antibiotic treatment or intralesional injection of interferon alfa-2a should be considered as a first-line treatment of Borrelia burgdorferi-associated primary cutaneous B cell lymphoma before more aggressive conventional therapeutic modalities (e.g., radiation therapy) are applied.

Topics: Adult; Borrelia burgdorferi Group; Cefotaxime; Ceftriaxone; Doxycycline; Drug Administration Schedule; Drug Therapy, Combination; Humans; Injections, Intralesional; Interferon alpha-2; Interferon-alpha; Lyme Disease; Lymphoma, B-Cell; Male; Recombinant Proteins; Recurrence