RESUMO
Hepatocellular carcinoma (HCC) is the 2nd most common cause of cancer related death in Korea and well-known malignancy with poor prognosis. Sorafenib is the first-line molecular targeted agent in patients with extra-hepatic spread of HCC. However, complete response is extremely rare in patients treated with sorafenib and the disease control rate is only 43%. We report a 53-year-old man with advanced HCC with pulmonary metastasis who showed complete response by cytotoxic chemotherapy with doxorubicin and cisplatin with relatively tolerable adverse effects after failure of treatment with sorafenib.
Assuntos
Humanos , Pessoa de Meia-Idade , Carcinoma Hepatocelular , Cisplatino , Doxorrubicina , Tratamento Farmacológico , Coreia (Geográfico) , Metástase Neoplásica , PrognósticoRESUMO
When neurological symptoms occur during the treatment of acute lymphoblastic leukemia, the differential diagnosis includes a leukemic infiltration of the nervous system, drug toxicity, infection, and other neurological disorders. We describe a 16-year-old girl with acute lymphoblastic leukemia that appeared to be complicated by vincristine-induced peripheral and cranial polyneuropathy after induction chemotherapy. She presented with right ptosis six weeks after the first dose of vincristine, and her neurological symptoms progressed to peripheral polyneuropathy. She recovered from these neurological symptoms over the next three months. Leukemic involvement of the nervous system and other neurological disorders could be excluded as potential causes of the neurological symptoms. This report shows that vincristine-induced neurotoxicity should be considered as a cause of cranial neuropathy that develops during the treatment of acute lymphoblastic leukemia.
Assuntos
Adolescente , Humanos , Doenças dos Nervos Cranianos , Diagnóstico Diferencial , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Quimioterapia de Indução , Leucemia , Infiltração Leucêmica , Sistema Nervoso , Doenças do Sistema Nervoso , Polineuropatias , Leucemia-Linfoma Linfoblástico de Células Precursoras , VincristinaRESUMO
Klebsiella pneumoniae causes pyogenic infections in various sites, with the risk of which increases in patients with diabetes mellitus. Recently, K. pneumoniae has emerged as a leading cause of pyogenic liver abscess. Primary liver abscess caused by K. pneumoniae in the absence of underlying hepatobiliary disease is commonly associated with metastatic infections such as endophthalmitis, meningitis, brain abscess and infection in other sites. We experienced a case of K. pneumoniae liver abscess associated with septic metastatic lesions including pyomyositis and infected aneurysm of aorta. Despite the aggressive management with antibiotics, surgical pus drainage and aortic bypass graft, patient died of ventilator associated pneumonia and multiorgan failure. Our experience suggests that clinicians should be alert to septic metastatic infections when they treat a patient with K. pneumoniae liver abscess.
Assuntos
Humanos , Aneurisma Infectado , Antibacterianos , Aorta , Aneurisma Aórtico , Abscesso Encefálico , Diabetes Mellitus , Drenagem , Endoftalmite , Klebsiella , Klebsiella pneumoniae , Fígado , Abscesso Hepático , Abscesso Hepático Piogênico , Meningite , Pneumonia , Pneumonia Associada à Ventilação Mecânica , Piomiosite , Supuração , TransplantesRESUMO
Mycobacterium fortuitum is a rare pathogen, frequently found in water, soil, animals and plant materials. It can cause infections involving skin, soft tissue and skeletal system after direct inoculation of the pathogen through surgical traumas, punctures and injections. We report a case of infrapatellar bursitis caused by M. fortuitum in an immunocompetent, 42-year-old female, which occurred after bicycle trauma. She experienced marked improvement after surgical excision and debridement of the wound site and antimicrobial therapy.
Assuntos
Adulto , Animais , Feminino , Humanos , Bursite , Desbridamento , Mycobacterium , Mycobacterium fortuitum , Plantas , Punções , Pele , SoloRESUMO
Klebsiella pneumoniae causes pyogenic infections in various sites, with the risk of which increases in patients with diabetes mellitus. Recently, K. pneumoniae has emerged as a leading cause of pyogenic liver abscess. Primary liver abscess caused by K. pneumoniae in the absence of underlying hepatobiliary disease is commonly associated with metastatic infections such as endophthalmitis, meningitis, brain abscess and infection in other sites. We experienced a case of K. pneumoniae liver abscess associated with septic metastatic lesions including pyomyositis and infected aneurysm of aorta. Despite the aggressive management with antibiotics, surgical pus drainage and aortic bypass graft, patient died of ventilator associated pneumonia and multiorgan failure. Our experience suggests that clinicians should be alert to septic metastatic infections when they treat a patient with K. pneumoniae liver abscess.
Assuntos
Humanos , Aneurisma Infectado , Antibacterianos , Aorta , Aneurisma Aórtico , Abscesso Encefálico , Diabetes Mellitus , Drenagem , Endoftalmite , Klebsiella , Klebsiella pneumoniae , Fígado , Abscesso Hepático , Abscesso Hepático Piogênico , Meningite , Pneumonia , Pneumonia Associada à Ventilação Mecânica , Piomiosite , Supuração , TransplantesRESUMO
Mycobacterium fortuitum is a rare pathogen, frequently found in water, soil, animals and plant materials. It can cause infections involving skin, soft tissue and skeletal system after direct inoculation of the pathogen through surgical traumas, punctures and injections. We report a case of infrapatellar bursitis caused by M. fortuitum in an immunocompetent, 42-year-old female, which occurred after bicycle trauma. She experienced marked improvement after surgical excision and debridement of the wound site and antimicrobial therapy.