Leuconostoc sp. Meningitis in a Patient Treated with Rituximab for Mantle Cell LymphomaHrvoje Holik1, Bozena Coha1, Marijan Sisko2, Maja Tomic-paradzik31General Hospital Dr. Josip Benčević, Clinic of Internal Medicine, Slavonski Brod, Croatia
2General Hospital Dr. Josip Benčević, Clinic of Infectious Diseases, Slavonski Brod, Croatia
3Public Health Institute of the Brod-Posavina County, Department of Microbiology, Slavonski Brod, Croatia
We present a 64-year-old man who was treated with R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemoimmunotherapy for mantle cell lymphoma and developed purulent meningitis, probably caused by Leuconostoc sp. The patient had severe hypogammaglobulinemia, which is a possible complication of rituximab therapy. To our knowledge and after reviewing the available medical literature, this is the first described case of purulent meningitis caused by Leuconostoc sp. in a patient with mantle cell lymphoma that appeared after treatment with the R-CHOP protocol. The diagnosis of purulent meningitis was based on clinical, laboratory and cytological cerebrospinal fluid findings, in addition to blood culture results in which we isolated Leuconostoc sp. The patient was treated with meropenem with full recovery. Keywords: Rituximab, Leuconostoc, Purulent meninigitis, Mantle cell lymphoma, R-CHOP
Mantle Hücreli Lenfoma Tanısı ile Rituksimab Kullanan Bir Hastada Leuconostoc MenenjitiHrvoje Holik1, Bozena Coha1, Marijan Sisko2, Maja Tomic-paradzik31General Hospital Dr. Josip Benčević, Clinic of Internal Medicine, Slavonski Brod, Croatia
2General Hospital Dr. Josip Benčević, Clinic of Infectious Diseases, Slavonski Brod, Croatia
3Public Health Institute of the Brod-Posavina County, Department of Microbiology, Slavonski Brod, Croatia
Burada mantle hücreli lenfoma tanısı ile R-CHOP (rituksimab, siklofosfamid, doksorubisin, vinkristin, prednizolon) kemoimmünoterapisi ile tedavi edilen ve muhtemelen Leuconostoc cinsi etkene bağlı pürülan menenjit gelişen 64 yaşında bir erkek hastayı sunuyoruz. Hastanın rituksimab tedavisinin olası komplikasyonlarından biri olan ağır hipogammaglobulinemisi bulunmakta olup, bildiğimiz kadarı ile ve mevcut tıbbi literatürün taranması sonrasında, olgumuz R-CHOP protokolü ile tedavi sonrası Leuconostoc cinsi etkene bağlı pürülan menejit gelişen mantle hücreli lenfoma tanılı ilk hastadır. Pürülan menenjit tanısı klinik bulgular, laboratuvar ve beyin-omurilik sıvısının sitolojik bulguları ve Leuconostoc izole ettiğimiz kan kültürünü temel alıyordu. Hasta meropenem tedavisi ile tamamen iyileşti. Anahtar Kelimeler: Rituksimab, Leuconostoc, Pürülan menenjit, Mantle hücreli lenfoma, R-CHOP
Hrvoje Holik, Bozena Coha, Marijan Sisko, Maja Tomic-paradzik. Leuconostoc sp. Meningitis in a Patient Treated with Rituximab for Mantle Cell Lymphoma. Turk J Hematol. 2015; 32(3): 271-274
Corresponding Author: Hrvoje Holik, Croatia |
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