Septic Shock Induced by Serratia marcescens Complicating Adult T-cell Leukemia (ATL)

A 75-year-old woman was admitted with fever of unknown origin and liver damage, and treated withprednisolone. Hypercalcemia appeared when of the dose of prednisolone was reduced, and human T-celllymphotropic virus type-I (HTLV-I) proviral DNA was detected in the leukemic cells by Southern blot analy...

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Veröffentlicht in:Kansenshogaku Zasshi 2006/05/20, Vol.80(3), pp.257-261
Hauptverfasser: OKA, Satoko, YOKOTE, Taiji, AKIOKA, Toshikazu, HARA, Satoshi, KOBAYASHI, Kichinosuke, HIRATA, Yuuji, TUJI, Motomu, HANAFUSA, Toshiaki
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Sprache:jpn
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Zusammenfassung:A 75-year-old woman was admitted with fever of unknown origin and liver damage, and treated withprednisolone. Hypercalcemia appeared when of the dose of prednisolone was reduced, and human T-celllymphotropic virus type-I (HTLV-I) proviral DNA was detected in the leukemic cells by Southern blot analysis, and a diagnosis of acute adult T-cell lymphoma (ATL) was made. After chemotherapy with sobuzoxanewas started, she went into septic shock caused by multiple resistant Serratia marcesense, and was treatedwith PMX-DHP and antibiotics. Although ner general condition and her serum cytokine leyels improved, theseptic shock became more severe, and the patient died. Serratia marcesense expreses lipopolysaccharide (LPS), a biologically active substance that is present ingram-negative bacteria.Exposure to LPS leads to activation of cytoklnes, including TNF-α, IL-1β, IL-6, andIFN-γ.After treatment withPMX-DHP, the patien, s general condition improved, but she died of septicshock. Bacterial infection may be a life-threatening complication in the immunocompromised hosts and elderlypatients, particularly when granulocytopenia has been induced by chemotherapy, and thus such thesepatients require careful management.
ISSN:0387-5911
1884-569X
DOI:10.11150/kansenshogakuzasshi1970.80.257