ABSTRACT
An 87-year-old woman presented to the emergency department with left thigh pain, and sciatic nerve pain was diagnosed. A chest CT scan showed bronchiectasis and tree-in buds and an acid-fast stain test of gastric juice was positive; further, M. avium-PCR of sputum and culture results were positive leading to a diagnosis of pulmonary nontuberculous mycobacterial infection(NTM). Abdominal CT showed dilatation of the main pancreatic duct and a multifocal cystic tumor in the pancreatic tail, which was found to be complicated with an intraductal papillary mucinous tumor(IPMN).
Subject(s)
Mycobacterium Infections, Nontuberculous , Pancreatic Neoplasms , Humans , Female , Aged, 80 and over , Pancreatic Neoplasms/complications , Mycobacterium Infections, Nontuberculous/complications , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/microbiology , Adenocarcinoma, Mucinous/complications , Adenocarcinoma, Mucinous/diagnosis , Pancreatic Intraductal Neoplasms/complicationsABSTRACT
A 76-year-old woman was operated on for rectal cancer in 2011 without chemotherapy and was followed up in the outpatient department. Decrease in white blood cell count was observed from 2013, and she developed anemia in 2015. Bone marrow aspiration was performed, and she was diagnosed with acute myeloid leukemia with myelodysplasia-related changes (AML/MRC). First, remission induction therapy was initiated with idarubicin and cytarabine administration, but pneumonia and vertebral osteomyelitis developed during the neutropenic period. Although the progress of antibiotics aided in the improvement of the recent prognosis of vertebral osteomyelitis compared with the past, poor prognosis with high death rate was still inevitable. Then, consolidation therapy was initiated with azacitidine (AZA) administration, and treatment was carried out for vertebral osteomyelitis with several antibiotics in parallel, which together led to the successful treatment of vertebral osteomyelitis while maintaining a remission state of AML. Because AZA is known to be well-tolerated and neutropenic phase is shorter than intensive chemotherapy in general, it can be an effective treatment option for patients who need both infection control and AML treatment.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Myeloid, Acute/drug therapy , Osteomyelitis/etiology , Pneumonia/etiology , Spinal Diseases/etiology , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Female , Humans , Induction Chemotherapy , Leukemia, Myeloid, Acute/complications , Osteomyelitis/drug therapy , Spinal Diseases/drug therapy , Treatment OutcomeABSTRACT
Here we report a case of Churg-Strauss syndrome (CSS) and central retinal artery occlusion (CRAO), with good visual recovery. A 58-year-old Japanese man with CSS experienced acute painless loss of vision in his right eye. CRAO was diagnosed by fundoscopic findings (retinal whitening with a cherry-red spot). Steroid pulse therapy (methylprednisolone at 1 g daily for 3 days) followed by combined treatment with prednisolone (30 mg/day) and cyclophosphamide (150 mg/day) was administered; his visual acuity recovered to 20/30 in 1 month, and no recurrence has occurred for 1 year. Steroid pulse therapy may be effective for CRAO in CSS patients.
