Mycobacteremia in patients with haematologic malignancies

Authors

  • Ana María Urdaneta Universidad de la Sabana
  • Guillermo Potdevin Universidad de la Sabana
  • Patricia Arroyo Instituto Nacional de Cancerología
  • Sonia Isabel Cuervo Instituto Nacional de Cancerología
  • Jorge Alberto Cortés Instituto Nacional de Cancerología

Keywords:

mycobacterium, leukemia/complications, multiple myeloma/complications, fever of unknown origin
Abstract Authors References How to Cite

Abstract

In patients with cancer, fever of unknown origin can be caused by some infections of difficult diagnosis. Here we describe two cases of fatal mycobacteremia. The former in a patient with acute lymphoid leukemia who developed pleural effusions, empyema and febrile neutropenia, and whose thoracic Computed Tomography (CT) showed multiple nodules that resembled mycotic infection. He was treated with amphotericin B without significant improvement. At 61th hospital day blood cultures grew mycobacteria. Treatment with antituberculous agents was started. Seven days later the patient died. In the second patient, the inicial presentation was fever of unknown origin. He has history of multiple myeloma and bone marrow transplantation five years ago. During his hospitalization he developed neutropenia and pancytopenia. Bone marrow biopsies revealed myelodysplasic syndrome. CT showed mediastinal lymphadenopathies that could not be sampled because of the presence of trombocytopenia. Blood cultures obtained at 8th day yielded mycobacteria. At 9th hospital day the patient died. Mycobacteremia is an unusual finding in patients with hematologic malignancies and is an infectious cause of fever of unknown origin in these patients.

Author Biographies

Ana María Urdaneta, Universidad de la Sabana

Facultad de Medicina, Universidad de la Sabana, Bogotá, D.C., Colombia

Guillermo Potdevin, Universidad de la Sabana

Facultad de Medicina, Universidad de la Sabana, Bogotá, D.C., Colombia

Patricia Arroyo, Instituto Nacional de Cancerología

Grupo Laboratorio de Microbiología, Instituto Nacional de Cancerología E.S.E., Bogotá, D.C., Colombia

Sonia Isabel Cuervo, Instituto Nacional de Cancerología

Grupo de Infectología, Instituto Nacional de Cancerología E.S.E., Bogotá, D.C., Colombia

Jorge Alberto Cortés, Instituto Nacional de Cancerología

Grupo de Infectología, Instituto Nacional de Cancerología E.S.E., Bogotá, D.C., Colombia

References

Sarmiento MC. Enfermedades transmisibles en Colombia: cambios ambivalentes. Rev Salud Pública (Bogotá) 2000;2:82-93.

Idrovo AJ. Raíces históricas, sociales y epidemiológicas de la tuberculosis en Bogotá, Colombia. Biomédica 2004;24:356-65.

https://doi.org/10.7705/biomedica.v24i4.1285

Fuller DD, Davis TE, Denys GA, York MK. Evaluation of Bactec Myco/F Lytic medium for recovery of Mycobacteria, fungi, and bacteria from blood. J Clin Microbiol 2001;3:2933-6.

https://doi.org/10.1128/JCM.39.8.2933-2936.2001

Crump JA, Tanner DC, Mirrett S, McKnight CM, Reller LB. Controlled comparison of Bactec 13A, Myco/F Lytic, BacT/Alert MB, and Isolator 10 systems for detection of mycobacteremia. J Clin Microbiol 2003;41:1987-90.

https://doi.org/10.1128/JCM.41.5.1987-1990.2003

Grinsztejn B, Fandinho FC, Veloso VG, Joao EC, Lourenco MC. Mycobacteremia in patients with the acquired immunodeficiency syndrome. Arch Intern Med. 1997;157(20):2359-63.

https://doi.org/10.1001/archinte.1997.00440410091010

Horsburgh CR Jr, Metchock B, Gordon SM, Havlik JA Jr, McGowan JE Jr. Predictors of survival in patients with AIDS and disseminated Mycobacterium avium complex disease. J Infect Dis 1994;170:573-7.

https://doi.org/10.1093/infdis/170.3.573

Kemper CA, Havlir D, Bartók AE, Kane C, Camp B. Transient bacteremia due to Mycobacterium avium complex in patients with AIDS. J Infect Dis 1994;170:488-93.

https://doi.org/10.1093/infdis/170.2.488

Tuncer S, Tekin MI, Ozen H, Bilen C, Unal S, Remzi D. Detection of bacillus Calmette-Guerin in the blood by the polymerase chain reaction method of treated bladder cancer patients. J Urol 1997;158:2109-12.

https://doi.org/10.1016/S0022-5347(01)68169-2

Proctor DD, Chopra S, Rubenstein SC, Jokela JA, Uhl L. Mycobacteremia and granulomatous hepatitis following initial intravesical bacillus Calmette-Guerin instillation for bladder carcinoma. Am J Gastroenterol 1993;88:1112-5.

Ker CC, Hung CC, Sheng WH, Chang SC, Luh KT. Fatal mycobacteremia caused by Mycobacterium tu berculosis in a patient with acute leukemia. Leukemia 1999;13:646-7.

https://doi.org/10.1038/sj.leu.2401380

Thaker H, Neilly IJ, Saunders PG, Magee JG, Snow MH, Ong EL. Remember mycobacterial disease in hairy cell leukaemia (HCL). J Infect 2001;42:213-4.

https://doi.org/10.1053/jinf.2001.0816

Talbot EA, Reller LB, Frothingbam R. Bone marrow cultures for the diagnosis of mycobacterial and fungal infections in patients infected with the human immu nodeficiency virus. Int J Tuberc Lung Dis 1999;3:908- 12.

Yuen KY;Woo PC. Tuberculosis in blood and marrow transplant recipients. Hematol Oncol 2002;20:51-62.

https://doi.org/10.1002/hon.681

Ministerio de Salud de Colombia. Programa Nacional de la Prevención y Control de la Tuberculosis. Guia de la Atención de la Tuberculosis Pulmonar y Extrapul monar. 2001:1-47.

Chin DP, Reingold AL, Stone EN, Vittinghoff E, Horsburgh CR Jr, Simon EM, et al. The impact of Mycobacterium avium complex bacteremia and its treatment on survival of AIDS patients: a prospective study. J Infect Dis 1994;170:578-84.

https://doi.org/10.1093/infdis/170.3.578

How to Cite

[1]
Urdaneta, A.M. et al. 2005. Mycobacteremia in patients with haematologic malignancies. Revista Colombiana de Cancerología. 9, 2 (Jun. 2005), 54–59.

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Published

2005-06-01

Issue

Vol. 9 No. 2 (2005)

Section

Reportes de caso

License

Todos los derechos reservados. 

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