1/41. vancomycin-induced neutropenia associated with fever: similarities between two immune-mediated drug reactions.A 39-year-old woman being treated for osteomyelitis with vancomycin developed severe neutropenia and drug fever. After she discontinued therapy, both disorders quickly resolved. These adverse reactions have rarely been reported with vancomycin, and share many similarities with regard to clinical features and postulated mechanisms of induction. To our knowledge this is the first case documenting drug fever as a principal component of vancomycin-induced neutropenia, and provides further evidence in support of an immune-mediated mechanism.- - - - - - - - - - ranking = 1keywords = neutropenia (Clic here for more details about this article) |
2/41. typhlitis complicating autologous blood stem cell transplantation for breast cancer.Three cases of typhlitis occurring during autologous blood stem cell transplantation (ABSCT) for metastatic breast cancer are described. typhlitis is a rare complication of neutropenia and has uncommonly been reported in the autologous transplant setting. Although it has been most commonly described in children with leukemia, typhlitis has increasingly been reported in adult leukemias and in association with neutropenia secondary to chemotherapy for a number of solid tumors. Only five previous cases of typhlitis in the setting of ABSCT have been described. Whereas diarrhea and fever are common toxicities associated with high-dose chemotherapy, it is likely that many cases of typhlitis go unrecognized. bone marrow transplantation (2000) 25, 321-326.- - - - - - - - - - ranking = 0.33333333333333keywords = neutropenia (Clic here for more details about this article) |
3/41. Respiratory distress secondary to both amphotericin b deoxycholate and lipid complex formulation.A 73-y-old female with a history of adenocarcinoma of colon and refractory anemia developed febrile neutropenia following chemotherapy. Therapy with iv infusion of amphotericin b deoxycholate (AmBd) was initiated on day 8 of hospital admission. Premedications included acetaminophen, diphenhydramine and meperidine. Patient developed rigor, chill and elevated temperature approximately 100 min into the infusion. The infusion was temporarily discontinued and rigors subsided following administration of 25 mg meperidine im. Infusion was continued after cessation of the rigors with no further sequelae. During each infusion of AmBd over the next 3 d, the patient developed rigor, chill and elevated temperature which was managed with meperidine. However, on day 4 she developed respiratory distress, bronchospasm and visible cyanosis with oxygen saturation of 88% while on 2 L oxygen. The infusion was stopped and the symptoms subsided with administration of albuterol via nebulizer. Amphotericin lipid formulation infusion was reinstituted after 3 d because of the patient's worsening clinical status. However, the patient developed severe respiratory distress approximately 130 min into the infusion. The infusion was discontinued and she was treated with albuterol via nebulizer. itraconazole therapy was instituted without any adverse sequelae. Clinicians should be aware of this potential adverse event since it can occur with all formulation of amphotericin.- - - - - - - - - - ranking = 41.663747980749keywords = febrile neutropenia, neutropenia (Clic here for more details about this article) |
4/41. Disseminated mucormycosis caused by absidia corymbifera leading to cerebral vasculitis.An 18-year-old woman was admitted to hospital because of subcutaneous hematoma and fever of unknown origin. Acute myeloid leukemia was diagnosed and empirical antimicrobial treatment and induction chemotherapy were started. After initial defervescence, fever relapsed 2 days after the onset of neutropenia. The CT scan of the lung was consistent with an invasive fungal infection. Treatment with amphotericin b was started and antimicrobial treatment was continued with liposomal amphotericin b because of an increase in creatinine later. The fever persisted and the patient suddenly developed progressive neurological symptoms. CT scan of the head suggested cerebral infarction and angiography of the extra- and intracranial arteries showed signs of vasculitis. Six days after the onset of neurological symptoms cerebral death was diagnosed. autopsy revealed non-septate, irregularly branched hyphae in various histologic sections including brain. absidia corymbifera could be isolated from lung tissue confirming the diagnosis of disseminated mucormycosis. In this case, angiographic findings suggested severe cerebral vasculitis which was in fact caused by thromboembolic dissemination of fungal hyphae. This case underlines the fact that cerebral symptoms in febrile neutropenic patients are highly indicative for fungal infections of the brain.- - - - - - - - - - ranking = 0.16666666666667keywords = neutropenia (Clic here for more details about this article) |
5/41. Kikuchi's disease: report of 2 cases and a brief review of the literature.Kikuchi's lymphadenitis is a histiocytic necrotizing lymphadenitis without granulocytic infiltration, with fever and generally with a benign course, despite its pathologic resemblance to malignant lymphoma. The illness usually begins with localized cervical adenopathy in young adult females, predominantly before the fourth decade of life. Clinically, several agents could be the cause of such an illness--toxoplasmosis, herpes group viral infection, cat scratch disease, lymphoma, SLE and other infectious agents. The diagnosis is made by using a histological technique. The lymph node biopsy reveals fibrinoid necrosis, loss of lymph node structure with many histiocytes and an absence of granulomatous reaction. The immunohistochemical analysis shows that the main affected cellular components are the T cells. Laboratory exams show an erythrocyte sedimentation increase, neutropenia, leukopenia and lymphocytosis. We describe two cases that were followed since 1994 and 1996, respectively. Both were females under 25 years old, who developed a febrile disease with lymphadenopathy. Lymph node biopsies showed necrotizing lymphadenitis without granulocytic infiltrations. The patients had no evidence of other systemic diseases. Our objectives are to present a rare cause of febrile disease with enlargement of cervical lymph nodes, to review Kikuchi's disease, and to alert the medical community to this rare cause of fever and lymphadenopathy.- - - - - - - - - - ranking = 0.16666666666667keywords = neutropenia (Clic here for more details about this article) |
6/41. Transient fungemia due to rhodotorula rubra in a cancer patient: case report and review of the literature.A unique case of rhodotorula rubra transient fungemia in a post-chemotherapy, febrile neutropenic patient with colon cancer, suffering from gastrointestinal mucositis, is described. The fungus was isolated repeatedly from his blood. However, all signs and symptoms of the infection disappeared, without antifungal treatment, as soon as neutropenia and mucositis, both of short duration, resolved. Restoration of the patient's defense mechanisms was adequate for disappearance of the fungus from the patient's blood and full recovery.- - - - - - - - - - ranking = 0.16666666666667keywords = neutropenia (Clic here for more details about this article) |
7/41. ehrlichiosis infection in a 5-year-old boy with neutropenia, anemia, thrombocytopenia, and hepatosplenomegaly.ehrlichiosis should be considered in the differential diagnosis of any patient with recent fever, pancytopenia, hepatosplenomegaly, and history of tick exposure. We present a previously healthy 5-year-old boy who was referred to the hematology-Oncology Clinic to consider a bone marrow etiologic process after his pediatrician discovered progressive neutropenia, anemia, thrombocytopenia, and hepatosplenomegaly accompanied by 2 days of fever. Bone marrow aspirate and biopsy were nonrevealing. Because of the history of a recent tick bite, a diagnosis of ehrlichiosis infection was considered and ultimately confirmed by IgG-specific serum testing. The patient's fever was treated symptomatically with acetaminophen, and symptoms resolved on their own without intervention. ehrlichiosis is a tick-borne infection that occurs throughout the spring and summer, often causing findings that mimic a malignancy or serious hematologic disorder. The diagnosis should be considered in any person living in tick-infested areas and can be confirmed by polymerase chain reaction or serum antibody titers. Treatment with doxycycline can lead to rapid clinical improvement if the diagnosis is made early.- - - - - - - - - - ranking = 0.83333333333333keywords = neutropenia (Clic here for more details about this article) |
8/41. Fevers and mouth ulcers.mouth ulcers are commonly caused by infection but may be due to neutropenia. The most common form of hyper-IgM syndrome is of X-linked inheritance and caused by cd40 ligand gene mutations. Consider hyper-IgM syndrome in a male child with recurrent bacterial or opportunistic infections, neutropenia, hypogammaglobulinaemia (IgG and IgA) and normal T- and B-cell counts. In X-linked hyper-IgM syndrome: - the serum IgM concentration is normal in about 50% of cases. - transient or persistent neutropenia occurs in 70% of cases. First-line therapeutic options for hyper-IgM syndrome include regular intravenous immunoglobulin and prophylactic trimethoprimsulphamethoxazole.- - - - - - - - - - ranking = 0.5keywords = neutropenia (Clic here for more details about this article) |
9/41. Cyclic neutropenia and pyomyositis: a rare cause of overwhelming sepsis.Primary pyomyositis is a pyogenic infection of skeletal muscle with abscess formation, which traditionally lacks an identifiable cause. We present a case of pyomyositis for which a cause was established. This was largely due to the fact that the patient was young and fit, enabling him to survive such overwhelming sepsis long enough for cycling of his neutrophil count to become apparent. Having had multiple abscesses drained, he was successfully treated with granulocyte colony stimulating factor and has remained well since.- - - - - - - - - - ranking = 0.66666666666667keywords = neutropenia (Clic here for more details about this article) |
10/41. Uncommon vancomycin-induced side effects.vancomycin has been used with increased frequency during the past 15 years and the most common toxicity with this drug is the red man syndrome . Other adverse effects include neutropenia, fever, phlebitis, nephrotoxicity, ototoxicity, thrombocytopenia, interstitial nephritis, lacrimation, linear iga bullous dermatosis, necrotizing cutaneous vasculitis and toxic epidermal necrolysis. Only two cases of vancomycin-induced stevens-johnson syndrome and one case of pancytopenia have been reported in the medical literature. The treatment for both situations is based on cessation of the vancomycin therapy; in cases of stevens-johnson syndrome, antihistamine and/or steroid agents can be used. This article reports a case of pancytopenia and a case of erythema major associated with neutropenia.- - - - - - - - - - ranking = 0.33333333333333keywords = neutropenia (Clic here for more details about this article) |
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