Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/patologia , Linfoma Folicular/tratamento farmacológico , Linfoma Folicular/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Murinos/administração & dosagem , Cloridrato de Bendamustina , Humanos , Masculino , Compostos de Mostarda Nitrogenada/administração & dosagem , Prednisona/administração & dosagem , Indução de Remissão , RituximabRESUMO
BACKGROUND: The multiple myeloma has the highest incidence among tumors of the bone and the bone marrow. Due to its rather mild and uncharacteristic clinical onset, first diagnosis of multiple myeloma is often delayed. CASE REPORT: The case of a 60-year-old female patient is reported who had been admitted to the authors' hospital in a state of severe septicemia. The patient's medical history had been unremarkable, apart from osteoporotic complaints. Smears of both peripheral blood as well as bone marrow samples showed a massive streptococcal infestation as demonstrated by light microscopy. In addition, plasma cells were the dominant cell type in these samples allowing the diagnosis of a yet unknown full-blown multiple myeloma. CONCLUSION: The case suggests that in the event of indistinct bone ache, a routine serum electrophoresis is advisable to minimize the risk of missing an underlying multiple myeloma.
Assuntos
Mieloma Múltiplo/diagnóstico , Infecções Pneumocócicas/etiologia , Choque Séptico/etiologia , Biópsia por Agulha , Medula Óssea/patologia , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Mieloma Múltiplo/patologia , Plasmócitos/patologia , Infecções Pneumocócicas/patologia , Choque Séptico/patologiaRESUMO
Usually identification of the causative bacteria for an episode of sepsis is achieved using microbiological culture of blood or body fluid. In the case of pleural effusion and fever, a microscopic examination of the pleural effusion smear to identify the bacteria responsible should be performed immediately to optimize the selection of antibiotic therapy regimen.