TY - JOUR
T1 - Listeria brain abscess, Pneumocystis pneumonia and Kaposi's sarcoma after temozolomide
AU - Ganière, Vincent
AU - Christen, Grégoire
AU - Bally, Frank
AU - Guillou, Louis
AU - Pica, Alessia
AU - de Ribaupierre, Sandrine
AU - Stupp, Roger
PY - 2006/6
Y1 - 2006/6
N2 - 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.
AB - 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.
KW - Glioblastoma multiforme
KW - Kaposi's sarcoma
KW - Listeria monocytogenes
KW - Pneumocystis jiroveci
KW - Temozolomide
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U2 - 10.1038/ncponc0514
DO - 10.1038/ncponc0514
M3 - Article
C2 - 16757971
AN - SCOPUS:33745045211
SN - 1743-4254
VL - 3
SP - 339
EP - 343
JO - Nature Clinical Practice Oncology
JF - Nature Clinical Practice Oncology
IS - 6
ER -