ABSTRACT
BACKGROUND Subcutaneous panniculitis-like T cell lymphoma and primary cutaneous γdelta T cell lymphoma are rare forms of non-Hodgkin lymphoma presenting as skin nodules or plaques. CASE REPORT Here, we present a case of a 48-year-old man with multiple subcutaneous, tender, erythematous nodules on his right thigh and left arm. Multiple courses of antibiotics were administered with no significant improvement in the patient's lesions. The skin biopsy report showed CD3/CD8 lymphocytic rimming of the adipocytes and the patient was diagnosed with subcutaneous panniculitis-like T cell lymphoma. A subsequent bone marrow biopsy showed hemophagocytic lymphohistiocytosis. The patient underwent treatment with the cyclophosphamide, hydroxydaunorubicin, Oncovin, prednisone, and etoposide chemotherapy regimen and received an autologous peripheral blood stem cell transplant. CONCLUSIONS Nodular skin lesions can result from a variety of noninfectious causes in addition to bacterial and fungal infections. This case highlights the importance of early biopsy of skin lesions that do not respond to standard therapy to establish an accurate diagnosis and start timely treatment to prevent poor outcomes.
Subject(s)
Cellulitis/diagnosis , Lymphohistiocytosis, Hemophagocytic/complications , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphoma, T-Cell/complications , Lymphoma, T-Cell/diagnosis , Panniculitis/complications , Panniculitis/diagnosis , Diagnosis, Differential , Humans , Lymphohistiocytosis, Hemophagocytic/therapy , Lymphoma, T-Cell/therapy , Male , Middle Aged , Panniculitis/therapyABSTRACT
Respiratory syncytial virus (RSV) is a common cause of respiratory tract infections. In severely immunosuppressed patients RSV can cause significant morbidity and mortality. The only FDA-approved drug for RSV is aerosolized ribavirin. Given the high morbidity and mortality in high-risk populations and inconsistent results with aerosolized ribavirin, new strategies for prevention and treatment of RSV are being sought. Palivizumab is an RSV-specific monoclonal antibody. A randomized, double-blind, placebo-controlled multicenter study showed significant reduction in hospitalization rates among children at high risk of RSV infection who had been given prophylactic palivizumab; these findings led to palivizumab's approval by the FDA in June 1998. Palivizumab also has a role in prevention of severe respiratory tract infections in high-risk infants. In immunocompromised patients, palivizumab has an excellent safety profile and may be beneficial in the prevention and treatment of RSV infections; however, clinical trials are needed to determine its effectiveness. In this article, we review the role of palivizumab in prevention and treatment of RSV infections in immunocompetent and immunocompromised patients.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Antiviral Agents/therapeutic use , Respiratory Syncytial Virus Infections/drug therapy , Animals , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Humans , Immunocompromised Host , Palivizumab , Respiratory Syncytial Virus Infections/prevention & controlABSTRACT
Temozolomide is a relatively new chemotherapeutic agent frequently associated with selective CD4+ T-lymphocytopenia. Patients with cell-mediated immune defects are at higher risk for acquiring infections with Salmonella species. We describe the first case of disseminated salmonellosis in a patient treated with temozolomide.
