minocycline and Precursor-Cell-Lymphoblastic-Leukemia-Lymphoma

Reports of cases of mycobacterial infections after SCT are rare. We report a 30-year-old female with a cutaneous infection of Mycobacterium fortuitum 30 months after allogeneic bone marrow transplantation for acute lymphoblastic leukemia. The patient was successfully treated with surgical debridement followed by oral minocycline and clarithromycin. Mycobacterial infections should be considered in SCT patients with undiagnosed refractory chronic cutaneous infection, and surgical debridement is useful for the diagnosis and treatment of such infections.

Topics: Adult; Bone Marrow Transplantation; Clarithromycin; Combined Modality Therapy; Cyclosporine; Debridement; Drug Therapy, Combination; Female; Graft vs Host Disease; Humans; Immunocompromised Host; Immunosuppressive Agents; Methotrexate; Minocycline; Mycobacterium fortuitum; Mycobacterium Infections, Nontuberculous; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisolone; Remission Induction; Skin Ulcer; Tacrolimus; Transplantation Conditioning; Transplantation, Homologous

Corynebacterium jeikeium has been recognized as an important cause of infection, particularly among neutropenic patients who have central venous catheter (CVC). Routine use of tigecycline in children is not yet approved. Here in we present a child with relapsed-refractory lymphoblastic leukemia who was successfully treated with tigecyline due to multi-drug-resistant C. jeikeium sepsis without removal of CVC. Our case highlights the use of tigecycline where there are no alternatives. Further studies regarding the efficacy and safety of tigecycline in pediatric patients are needed.

Topics: Anti-Bacterial Agents; Catheter-Related Infections; Catheterization, Central Venous; Child; Corynebacterium Infections; Drug Resistance, Multiple; Female; Humans; Minocycline; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Recurrence; Remission Induction; Tigecycline

Actinomycosis is an uncommon infectious disease caused predominantly by Actinomyces israelii. The cutaneous disseminated form is usually caused by hematogenous dissemination from a primary extra-cutaneous lesion. We report here cutaneous disseminated actinomycosis without any detectable extra-cutaneous lesions in a 42-year-old Japanese woman with acute lymphocytic leukemia. Multiple soft nodules developed on her upper and lower extremities. Histopathological examination revealed "sulfur granules", which are a specific finding for actinomycosis. Cultures from biopsy specimens were not successful. There were no cervicofacial, thoracic, nor abdominal lesions. These findings suggest that cutaneous disseminated actinomycosis in our patient developed primarily in the skin. Although the patient was immunocompromised, antibiotic treatment with minocycline was effective.

Topics: Actinobacillus; Actinomycosis; Adult; Anti-Bacterial Agents; Antineoplastic Combined Chemotherapy Protocols; Arm; Bacteremia; Biopsy; Cytoplasmic Granules; Female; Humans; Immunocompromised Host; Leg Dermatoses; Minocycline; Opportunistic Infections; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Skin Diseases, Bacterial