Reactions 1704, p36 - 2 Jun 2018 Oral mucositis, Raoultella planticola infection and febrile neutropenia: case report A 16-year-old boy developed oral mucositis, Raoultella planticola infection and febrile neutropenia during treatment with vincristine, methotrexate, ifosfamide, cytarabine and etoposide for stage 3 Burkitt’s lymphoma [dosages and routes not stated]. The boy was admitted with a diagnosis of stage 3 Burkitt’s lymphoma. chemotherapy with vincristine, methotrexate, ifosfamide, cytarabine and etoposide was initiated and each cycle was administered for 5 days. Prior to the initiation of chemotherapy, dental assessment was performed and no periodontal lesions or caries were noted and oral hygiene grade was good. During the second cycle of the chemotherapy, he developed grade 3 oral mucositis, induced by the chemotherapy. Oral manifestations included erosions of the lips and palate, atrophic lesions of the cheeks, ulcers on both palatine pillars. Symptoms included extreme difficulty in swallowing food and chewing and pain. A swab of the lesions was positive for the growth of Raoultella planticola. The ulcers had grew in size by almost 3cm over a period of 5 days and turned grey in colour. The pain increased to a severity of 8/10. His CRP level was 160 mg/L and procalcitonin level was 0.6 µg/L. He also developed febrile neutropenia. The boy was treated with amikacin and ceftazidime along with unspecified G-colony stimulating factor. His fever resolved within 72 hours. Subsequently, a complete biochemical assessment with repeated urine and blood cultures, multiple swabs and viral PCR was performed without any positive findings. Eight days after the initiation of antibiotics, complete resolution of the symptoms was observed and the mucosal lesions had healed completely. He was asymptomatic during the discharge and had normal blood values. Thereafter, the chemotherapy was continued as scheduled. He had no oral complaints 12 months after the infection. Author comment: "During the second cycle A. . .the patient developed a chemotherapy-induced oral mucositis grade 3". "Chemotherapy-related oral infections. . .contribute significantly to the morbidity and mortality. . .This case report highlights the need to now add Raoultella planticola to the list of bacteria encountered in the course of oral mucositis in patients undergoing chemotherapy" "Neutropaenia. . .remains the most common adverse event of anti-neoplastic chemotherapy." Bardellini E, et al. A new emerging oral infection: Raoultella planticola in a boy with haematological malignancy. European Archives of Paediatric Dentistry 18: 215-218, No. 3, Jun 2017. Available from: URL: http://doi.org/10.1007/ s40368-017-0279-7 - Italy 803322795 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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