Document Detail

Esophageal erosion as a possible bacterial entry site in an acute lymphoblastic leukemia patient with sepsis.
MedLine Citation:
PMID:  12774931     Owner:  NLM     Status:  MEDLINE    
A 69-year-old man with relapsed acute lymphoid leukemia was treated with adriamycin, vincristine, and prednisolone. During this chemotherapy, the patient developed sepsis and meningitis. Although many kinds of antimicrobial drugs, including imipenem, meropenem, amphotericin-B, and gamma-globulin were administered, the patient died of respiratory failure. A positive result for Enterococcus faecalis was obtained in both blood and cerebrospinal fluid culture. Autopsy revealed multiple small erosions in the lower esophagus. Histopathological examination showed multiple nuclear inclusion bodies of herpes simplex virus in the squamous epithelial cells at the edge of the erosions. Moreover, proliferation of micrococci was observed at the base of the erosions and in the lumina of the submucosal small vessels. These findings suggested that E faecalis entered the blood circulation from this lesion. In many patients with febrile neutropenia, the pathogenesis of infection remains unclear. Our case seems significant for clarifying the focus and pathogenesis of febrile neutropenia.
Satoshi Ikegaya; Akira Yoshida; Hiromichi Iwasaki; Hironobu Naiki; Takanori Ueda
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International journal of hematology     Volume:  77     ISSN:  0925-5710     ISO Abbreviation:  Int. J. Hematol.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-30     Completed Date:  2003-10-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9111627     Medline TA:  Int J Hematol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  395-8     Citation Subset:  IM    
Second Department of Pathology, Fukui Medical University, Yoshida-gun, Fukui, Japan.
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MeSH Terms
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use
Enterococcus faecalis
Esophageal Diseases / microbiology*
Fatal Outcome
Gram-Positive Bacterial Infections / etiology
Meningitis / etiology,  microbiology
Middle Aged
Neutropenia / chemically induced,  microbiology
Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*,  drug therapy
Respiratory Insufficiency
Sepsis / etiology*,  microbiology,  pathology

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