Abstract
The risk of developing secondary infections in immunocompromised patients due to hematological malignancies and the treatments for such conditions is very well known. Fever can be the only manifestation of a serious infection among this category of patients. The degree and duration of neutropenia is directly related to the risk of multiple infectious complications. When we are dealing with severely impaired host defenses virtually any microorganism can become invasive, bacteria (gram-positive pathogens, but gram-negative as well), being the greatest immediate threat. Multiple pathogens isolated from an immunocompromised host can represent a major challenge for the clinician, especially when we have to face multidrug resistant (MDR) microorganisms, also called “superbugs”. Besides, when we confront such a patient with many comorbidities and a high risk for MDR pathogens infection, we also confront with a lot of limitations in terms of treatment options. We present a complicated case of glycopeptide-resistant Enterococcus faecium sepsis secondary to Clostridium difficile colitis in a 63 years old female patient with B-cell non-Hodgkin Lymphoma (NHL) during the R-CHOP therapy.
Highlights
The risk of developing secondary infections in immunocompromised patients due to hematological malignancies and the treatments for such conditions is very well known
REVISTA ROMÂNÅ DE BOLI INFECoIOASE – VOLUMUL XVIII, NR. 4, AN 2015. Based on these data we interpreted the case as C. difficile associated diarrhea (CDAD) induced by chemotherapy and we initiated treatment with orally Vancomycin 500 mg q6hr
We took into consideration the following possible causes of persistent fever and diarrhea: Clostridium difficile (CD) relapse, sepsis with different etiology or Enterococcus faecium vancomycin resistant sepsis with in vivo induced resistance after drug exposure
Summary
The risk of developing secondary infections in immunocompromised patients due to hematological malignancies and the treatments for such conditions is very well known. Based on these data we interpreted the case as C. difficile associated diarrhea (CDAD) induced by chemotherapy and we initiated treatment with orally Vancomycin 500 mg q6hr. Despite antibiotic treatment according to antibiogram susceptibility and FMT for CDAD the patient failed to improve.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
