cefotaxime and Precursor-Cell-Lymphoblastic-Leukemia-Lymphoma

Thirty-three children with leukemia who had neutropenia and fever were randomized to receive cefataxim and amikacin, versus the same antibiotics plus intravenous gammaglobulin (i.v. IgG). Duration of neutropenia, hospitalization and the interruption of chemotherapy were not different in the two groups; however, duration of fever was significantly shorter in the i.v. IgG group.

Topics: Agranulocytosis; Amikacin; Antineoplastic Agents; Cefotaxime; Child; Drug Therapy, Combination; Fever; Humans; Immunoglobulin G; Immunoglobulins, Intravenous; Infection Control; Leukemia, Myeloid, Acute; Neutropenia; Precursor Cell Lymphoblastic Leukemia-Lymphoma

The incidence of infection with penicillin-non-susceptible Streptococcus pneumoniae is increasing rapidly worldwide. Spain and France are highly affected, whereas the level of penicillin resistance in Germany, Italy, The Netherlands and Scandinavia is low. We report a lethal episode of meningitis due to penicillin- and cefotaxime-intermediate S. pneumoniae in a 7-year-old, allogene bone marrow transplanted German boy, 5 weeks after a holiday in Spain. Three days prior to the infection the patient showed good performance status. He was in complete remission without signs of graft-versus-host disease (GVHD). He died on day 341 post bone marrow transplant (BMT), 2 days after the onset of meningitis. Penicillin-non-susceptible S. pneumoniae should be regarded as a potential infectious agent even in countries with a low prevalence of resistance.

Topics: Bone Marrow Transplantation; Cefotaxime; Cephalosporin Resistance; Child; Disease Progression; Drug Resistance, Multiple, Bacterial; Fatal Outcome; Germany; Humans; Male; Meningitis, Pneumococcal; Microbial Sensitivity Tests; Penicillin Resistance; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Risk Assessment; Streptococcus pneumoniae

The authors report a fatal case of acute bacterial myocarditis in a nonneutropenic child with acute lymphoblastic leukemia. She was admitted to the hospital with a urinary tract infection resulting from and remained persistently febrile despite resolution of the infection. On hospital day 4 signs of acute cardiac failure developed. Despite aggressive resuscitation measures, she died. Pathologic examination revealed the cause of death to be bacterial myocarditis. In addition, she was found to have a generalized decrease in her serum immunoglobulin levels. Acute bacterial myocarditis in patients with malignancy has been rarely reported. The rapid clinical deterioration and death in the patient in this report is particularly interesting.

Topics: Acute Disease; Agammaglobulinemia; Antineoplastic Combined Chemotherapy Protocols; Cefotaxime; Child; Drug Therapy, Combination; Fatal Outcome; Female; Humans; Immunocompromised Host; Klebsiella Infections; Klebsiella pneumoniae; Myocarditis; Oxacillin; Pericarditis; Pleurisy; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Remission Induction; Shoulder Pain; Tobramycin; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections

Topics: Cefotaxime; Cephalosporins; Child; Humans; Male; Nocardia asteroides; Nocardia Infections; Precursor Cell Lymphoblastic Leukemia-Lymphoma

A 6 year old boy receiving chemotherapy for acute lymphocytic leukaemia developed pneumonia due to Corynebacterium pseudodiphtheriticum. He responded to antibiotics.

Topics: Cefotaxime; Child; Corynebacterium Infections; Drug Resistance, Microbial; Humans; Male; Opportunistic Infections; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Respiratory Tract Infections