Sepsis caused by Listeria monocytogenes during chemotherapy for small cell carcinoma of the thymus.

Abstract

BACKGROUND:

Listeria monocytogenes is a facultative intracellular parasitic bacterium that is Gram positive, catalase positive, oxidase negative, and a facultative anaerobe. It is known to infect humans through food. It is a bacillus with low virulence, but can cause meningitis and sepsis in infants and immunocompromised patients.

CASE PRESENTATION:

A case of 75-year-old Japanese female with small cell carcinoma of the thymus and pleural dissemination is described. She was treated with carboplatin and etoposide and showed a partial response. However, the tumor recurred 6 months later. Therefore, we again administered carboplatin and etoposide. Though peritoneal dissemination was suspected based on abdominal computed tomography findings after two courses, the assessment was stable disease. She was occasionally treated for constipation. She developed chills, rigor, and diarrhea, necessitating admission on the 7th day of the third course of chemotherapy. We suspected intestinal infection, and cefepime was thus administered. However, her blood pressure dropped and neutropenia manifested on the 4th day of admission. We therefore switched the antibiotic from cefepime to meropenem and also administered granulocyte-colony stimulating factor. Listeria monocytogenes was detected by two blood cultures, and the antimicrobial medication was thus switched to ampicillin, in consideration of sensitivity. Her general condition improved and she was able to leave the hospital on the 19th day after admission.

CONCLUSIONS:

During chemotherapy, factors such as impaired bowel movements, malnutrition, and myeloablation can contribute to the development of severe infections. It is necessary to comprehensively assess a patient's state and treat all aspects of illness.

• Authors: Masamichi Itoga, Yuko Asari, Takeshi Morimoto, Kageaki Taima, Kunihiko Nakamura, Yoshihito Tanaka, Hisashi Tanaka, Shingo Takanashi, Hiroyuki Kayaba, Ken Okumura
• Journal: BMC research notes (BMC Res Notes) Vol. 8 Pg. 268 (Jun 26 2015) ISSN: 1756-0500 [Electronic] England
• PMID: 26111524 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Antineoplastic Agents
• Cephalosporins
• Thienamycins
• Granulocyte Colony-Stimulating Factor
• Etoposide
• Ampicillin
• Cefepime
• Carboplatin
• Meropenem

Topics

• Aged
• Ampicillin (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Antineoplastic Agents (administration & dosage, adverse effects)
• Carboplatin (administration & dosage, adverse effects)
• Carcinoma, Small Cell (drug therapy, pathology)
• Cefepime
• Cephalosporins (therapeutic use)
• Etoposide (administration & dosage, adverse effects)
• Female
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Humans
• Listeria monocytogenes (drug effects, pathogenicity, physiology)
• Listeriosis (drug therapy, etiology, microbiology, pathology)
• Meropenem
• Neoplasm Recurrence, Local (drug therapy, pathology)
• Sepsis (drug therapy, etiology, microbiology, pathology)
• Thienamycins (therapeutic use)
• Thymus Gland (drug effects, pathology)
• Thymus Neoplasms (drug therapy, pathology)
• Treatment Outcome