Cytarabine/idarubicin

Cytarabine/idarubicin Reactions 1680, p107 - 2 Dec 2017 Bacteraemia due to Enterococcus raffinosus and Leuconostoc lactis and febrile neutropenia: case report A 44-year-old woman developed gram-positive cocci bacteraemia and febrile neutropenia during treatment with cytarabine and idarubicin [dosages, routes and time to reaction onset not stated]. The woman, who was hospitalised with fever, fatigue and white blood cell count of 1.4 X 10 /L with 2.5% blasts and 41.5% neutrophils, was diagnosed with acute myeloid leukaemia with myelodysplasia-related changes. She was started on treatment with cytarabine and idarubicin. The woman was started on cefepime for febrile neutropenia, which was replaced by meropenem and later again replaced by doripenem. However, her febrile neutropenia was persistent. Gradually, she also developed abdominal pain and diarrhoea. On day 13 of induction chemotherapy, blood culture was found positive for Enterococcus raffinosus. Bacterial translocation from the gastrointestinal tract was suspected based on clinical symptoms. She was started on teicoplanin and dosage was adjusted according to the trough levels. But her fever, diarrhoea and abdominal pain persisted, despite negative blood culture results. On day 19, blood culture were again positive for gram-positive cocci. Severe bloodstream infection by glycopeptide-resistant gram-positive cocci was suspected. She was started on daptomycin instead of teicoplanin and Leuconostoc lactis infection was detected by using mass spectrometry. Bacteraemia due to Enterococcus raffinosus and Leuconostoc lactis was controlled by daptomycin. Since day 21, blood cultures were found negative and clinical improvement was observed. Daptomycin was stopped on day 39, after which complete remission of acute myeloid leukaemia and neutrophil recovery was achieved. Author comment: "Bacteremia during chemotherapy is a life-threatening event, because chemotherapy frequently induces neutropenia." "A 44-year-old woman with acute myeloid leukemia (AML) under myelosuppression suffered from teicoplanin-resistant gram-positive cocci bacteremia. . .Taking severe neutropenia due to chemotherapy and glycopeptide-resistance into account, teicoplanin was empirically substituted with daptomycin, which led to prompt defervescence." Matsuda K, et al. A therapeutic benefit of daptomycin against glycopeptide- resistant gram-positive cocci bloodstream infections under neutropenia. Journal of Infection and Chemotherapy 23: 788-790, No. 11, Nov 2017. Available from: URL: http://doi.org/10.1016/j.jiac.2017.06.010 - Japan 803285628 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Cytarabine/idarubicin

Reactions Weekly , Volume 1680 (1) – Dec 2, 2017
Free
1 page
Loading next page...
1 Page
 
/lp/springer_journal/cytarabine-idarubicin-A8wqVuTJTr
Publisher
Springer International Publishing
Copyright
Copyright © 2017 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-017-39038-8
Publisher site
See Article on Publisher Site

Abstract

Reactions 1680, p107 - 2 Dec 2017 Bacteraemia due to Enterococcus raffinosus and Leuconostoc lactis and febrile neutropenia: case report A 44-year-old woman developed gram-positive cocci bacteraemia and febrile neutropenia during treatment with cytarabine and idarubicin [dosages, routes and time to reaction onset not stated]. The woman, who was hospitalised with fever, fatigue and white blood cell count of 1.4 X 10 /L with 2.5% blasts and 41.5% neutrophils, was diagnosed with acute myeloid leukaemia with myelodysplasia-related changes. She was started on treatment with cytarabine and idarubicin. The woman was started on cefepime for febrile neutropenia, which was replaced by meropenem and later again replaced by doripenem. However, her febrile neutropenia was persistent. Gradually, she also developed abdominal pain and diarrhoea. On day 13 of induction chemotherapy, blood culture was found positive for Enterococcus raffinosus. Bacterial translocation from the gastrointestinal tract was suspected based on clinical symptoms. She was started on teicoplanin and dosage was adjusted according to the trough levels. But her fever, diarrhoea and abdominal pain persisted, despite negative blood culture results. On day 19, blood culture were again positive for gram-positive cocci. Severe bloodstream infection by glycopeptide-resistant gram-positive cocci was suspected. She was started on daptomycin instead of teicoplanin and Leuconostoc lactis infection was detected by using mass spectrometry. Bacteraemia due to Enterococcus raffinosus and Leuconostoc lactis was controlled by daptomycin. Since day 21, blood cultures were found negative and clinical improvement was observed. Daptomycin was stopped on day 39, after which complete remission of acute myeloid leukaemia and neutrophil recovery was achieved. Author comment: "Bacteremia during chemotherapy is a life-threatening event, because chemotherapy frequently induces neutropenia." "A 44-year-old woman with acute myeloid leukemia (AML) under myelosuppression suffered from teicoplanin-resistant gram-positive cocci bacteremia. . .Taking severe neutropenia due to chemotherapy and glycopeptide-resistance into account, teicoplanin was empirically substituted with daptomycin, which led to prompt defervescence." Matsuda K, et al. A therapeutic benefit of daptomycin against glycopeptide- resistant gram-positive cocci bloodstream infections under neutropenia. Journal of Infection and Chemotherapy 23: 788-790, No. 11, Nov 2017. Available from: URL: http://doi.org/10.1016/j.jiac.2017.06.010 - Japan 803285628 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680

Journal

Reactions WeeklySpringer Journals

Published: Dec 2, 2017

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off