Recurrent cellulitis due to Helicobacter cinaedi after chemotherapy for malignant lymphoma.

June 2012

Ishizawa J, Mori T, Tsukada Y, Matsuki E, Yokoyama K, Shimizu T, Sugita K, Murata M, Iwata S, Okamoto S.

Source

Division of Hematology, Department of Medicine, Keio University School of Medicine, Central Clinical Laboratory, Keio University Hospital.

Abstract

A 62-year-old man with diffuse large B-cell lymphoma received five courses of R-CHOP chemotherapy. The patient developedcellulitis in the bilateral lower extremities without fever, and blood culture yielded Helicobacter cinaedi after five-day culture. Although the response to tazobactam/piperacillin (TAZ/PIPC) was prompt, cellulitis recurred immediately after discontinuation of the drug. Even after two months of treatment with PIPC plus amikacin followed by amoxicillin, it recurred again soon after stopping the antibiotics. H. cinaedi reportedly causes bacteremia and cellulitis in immunocompromised patients mostly in patients with acquired immunodeficiency syndrome. Only sporadic cases have been reported in association with hematological malignancies. Physicians should be aware of H. cinaedi as one of the causative pathogens of bacteremia and cellulitis in patients with hematological malignancies. Longer incubation period of blood culture is needed to detect the microbe and long-term use of antimicrobials is required to prevent recurrent cellulitis.

Rinsho Ketsueki

Pemetrexed-induced cellulitis: A rare toxicity in non-small cell lung cancer treatment.

Feb 10, 2012

Katsenos S, Psara A, Panagou C.

Source

Department of Pneumonology, Army General Hospital of Athens, Athens, Greece.

Abstract

Pemetrexed is indicated for locally advanced or metastatic non-squamous non-small-cell lung cancer as an initial treatment in combination with cisplatin or after prior chemotherapy as a single agent. It is generally a well-tolerated drug.

The most common adverse reactions (incidence ≥20%) with single-agent use are fatigue, nausea, and anorexia. Additional common side effects when used in combination with cisplatin include vomiting, neutropenia, leukopenia, anemia, stomatitis/pharyngitis, thrombocytopenia, and constipation. Peripheral edema with associated erythema has rarely been described as an adverse effect. Herein, we report a patient with advanced non-small-cell lung cancer who experienced bilateral peripheral edema after pemetrexed administration.

Discontinuation of pemetrexed and corticosteroids use completely resolved peripheral edema.

PubMed