ro13-9904 and Carcinoma--Non-Small-Cell-Lung

The efficacy of preoperative antibiotic prophylaxis in thoracic surgery with a single dose of ceftriaxone was investigated. Here we report the results of a prospective study including 192 patients undergoing thoracic surgery for non small cell lung cancer. Overall, the postoperative infection rate, as measured by wound, respiratory tract, and urinary tract infections, was 8.3% (16/192). Ceftriaxone was well tolerated, and no allergic or other adverse reactions were reported. A single preoperative dose of ceftriaxone was cost-effective and allowed considerable saving of time, material, labor costs and money. This study, even though open and non-comparative, suggests that the routine use of a single preoperative dose of ceftriaxone provides a cost-effective prophylaxis for patients undergoing major thoracic operations.

Topics: Adult; Aged; Antibiotic Prophylaxis; Carcinoma, Non-Small-Cell Lung; Ceftriaxone; Cephalosporins; Female; Humans; Injections, Intravenous; Lung Neoplasms; Male; Middle Aged; Postoperative Complications; Prospective Studies; Pulmonary Surgical Procedures; Respiratory Tract Infections; Surgical Wound Infection; Urinary Tract Infections

A patient with painful peripheral neuropathy is presented, whose symptoms were thought to result from an infection with Borrelia burgdorferi sensu lato. Investigations of the cerebrospinal fluid for signs of inflammation and borrelial antibodies were negative, and the patient did not benefit from repeated antibiotic treatment. Electrophysiologic studies and sural nerve biopsy showed axonal neuropathy consistent with a paraneoplastic syndrome. Further workup revealed mediastinal Hodgkin's disease (HD; nodular sclerosing subtype) Ann Arbor stage II and non-small cell cancer of the lung (stage T1N0M0). Surgical resection of the lung cancer and combined chemo- and radiotherapy for HD resulted in complete remission of both malignancies. While the preexisting neurologic symptoms persisted during treatment, neurography showed some improvement of the distal nerves. During radiation therapy the patient developed transient left-sided brachial plexopathy. This case illustrates that the diagnosis of borreliosis in patients with isolated painful peripheral neuritis cannot be based solely upon positive IgG titers and supports the requirement for a thorough workup for an underlying--potentially curable--disease. In addition, singular pulmonary lesions in the setting of HD should be suspected to have a separate cause.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Biopsy; Carcinoma, Non-Small-Cell Lung; Ceftriaxone; Electrophysiology; Hodgkin Disease; Humans; Lung Neoplasms; Lyme Disease; Male; Paraneoplastic Polyneuropathy; Radiotherapy; Remission Induction; Sural Nerve; Tomography, X-Ray Computed