Trimethoprim-sulfamethoxazole salvage for refractory listeriosis during maintenance chemotherapy for acute lymphoblastic leukemia.
J Pediatr Hematol Oncol
; 22(4): 340-3, 2000.
Article
em En
| MEDLINE
| ID: mdl-10959905
ABSTRACT
A 5-year-old boy with acute lymphoblastic leukemia (ALL) and intolerance to oral trimethoprim-sulfamethoxazole (TMP/SMX) had Listeria monocytogenes bacteremia and meningitis develop during maintenance chemotherapy. Despite prompt administration of IV amoxicillin/gentamicin and microbiologic clearance of the bloodstream, the patient had no response to therapy after a course of 7 days. Intravenous TMP/SMX (10 mg/kg per day of TMP) was added to the antibiotic regimen after desensitization. Fever and meningeal signs rapidly resolved, and the patient was ultimately cured. Amoxicillin and gentamicin, although highly active and synergistic in vitro against L. monocytogenes, have limited intracellular penetration and activity. In contrast, TMP/SMX has bactericidal extracellular and intracellular activity against Listeria and excellent central nervous system penetration, and thus may be effective for the treatment of refractory listeriosis.
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Base de dados:
MEDLINE
Assunto principal:
Leucemia-Linfoma Linfoblástico de Células Precursoras B
/
Combinação Trimetoprima e Sulfametoxazol
/
Bacteriemia
/
Leucemia-Linfoma Linfoblástico de Células Precursoras
/
Meningite por Listeria
/
Anti-Infecciosos
Limite:
Child
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2000
Tipo de documento:
Article