mFOLFOX-based Chemotherapy Can Augment Survival in Advanced Gastric Cancer Patient with Disseminated Intravascular Coagulation

ABSTRACT Although gastric cancer is a frequent cancer type, disseminated intravascular coagulation is a very rare but serious complication of this disease. We report a 65-year-old man who complained of weight loss, nausea and vomiting, fatigue and dyspnoea for three days. He was diagnosed as having advanced gastric cancer complicated with disseminated intravascular coagulation, which was successfully treated with mFOLFOX chemotherapy regimen. After one cycle of mFOLFOX therapy, thrombocytopenia was improved and serum lactate dehydrogenase levels decreased. Remarkable remission was seen. After 12 cycles of chemotherapy, remarkable remission was seen in the primary tumour and multiple metastatic bone lesions.

Childhood pneumococcal meningitis: may it begin with diarrhea and proceed with cerebral infarct.

Pneumococcal meningitis does continue to be an important cause of mortality and morbidity in childhood despite widespread vaccination. It develops thorough invasion of the meninges by the agent via bloodstream. It may manifest typical signs of meningeal irritation and even the symptoms not belonging to the central nervous system, such as diarrhea. The diagnosis is made by microscopic evaluation and culture of cerebrospinal fluid (CSF) obtained by lumbar puncture. Despite the treatment, the risk of occurrence of cerebral and neurologic complications is high. A two-month old baby girl was presented to our outpatients’ clinic because of fever and diarrhea; she was diagnosed with pneumococcal meningitis and developed cerebral infarct during surveillance. The reason why we presented this patient is to highlight that meningitis due to pneumococ, one of the most common causing agents in childhood meningitis, may have clinical presentations other than expected.