Case Series of Extracorporeal Membrane Oxygenation during Acute Myelogenous Leukemia Induction

BackgroundAcute respiratory failure is a leading cause of intensive care unit admission in patients with hematological malignancies; it carries a mortality rate exceeding 50%. Venovenous extracorporeal membrane oxygenation use in patients with acute hematologic malignancies concurrently receiving induction chemotherapy is not well studied.Case presentationA 44-year-old male developed acute respiratory distress syndrome in the setting of newly diagnosed acute myelogenous leukemia. He underwent successful induction chemotherapy while on venovenous extracorporeal membrane oxygenation. His course was complicated by a devastating subarachnoid hemorrhage. Life support modalities were discontinued in accordance to the wishes of the family.ConclusionThere is a lack of data to guide use of induction chemotherapy in patients with acute hematologic malignancies requiring venovenous extracorporeal membrane oxygenation, particularly with regard to dosing, safety, and efficacy of chemotherapeutic agents. This case highlights a potential role of venovenous extracorporeal membrane oxygenation in select young acute myelogenous leukemia patients who might benefit from this intervention and warrants further research.

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Bacillus cereus Typhlitis in a Patient with Acute Myelogenous Leukemia: A Case Report and Review of the Literature

Case Reports in Infectious Diseases ◽

10.1155/2018/7510715 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

James D. Denham ◽

Sowmya Nanjappa ◽

John N. Greene

Keyword(s):

Bacillus Cereus ◽

Acute Myelogenous Leukemia ◽

English Language ◽

Neutropenic Patient ◽

Hematologic Malignancy ◽

Case Reports ◽

Clinical Manifestations ◽

Case Series ◽

Myelogenous Leukemia ◽

Acute Myelogenous

Bacillus cereus is a Gram-positive rod that is now recognized as a rare cause of frank disease in the neutropenic hematologic malignancy patient. Because this pathogen is rarely isolated in clinical specimens, no large studies exist to guide the management of these acutely ill patients. Individual case reports and case series exist in the literature describing various clinical manifestations of B. cereus in the neutropenic patient including bacteremia/septicemia, pneumonia, meningitis/encephalitis, hepatic abscesses, and gastritis. In this report, we describe a case of typhlitis caused by B. cereus in a 74-year-old female with recently diagnosed acute myelogenous leukemia (AML), and we summarize the available English language literature to draw tentative conclusions regarding the clinical manifestations of this organism.

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189. A Case Series of Elizabethkingia meningosepticum Bacteremia in the Cancer Population

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.264 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S114-S115

Author(s):

Dae Hyun Lee ◽

Ishita Mehra ◽

Sanjay Chandrasekhar ◽

Abu-Sayeef Mirza ◽

Rahul Shenoy ◽

...

Keyword(s):

Blood Culture ◽

Acute Myelogenous Leukemia ◽

Case Series ◽

Neutropenic Fever ◽

Myelogenous Leukemia ◽

Patient History ◽

Chest Port ◽

Stable Conditions ◽

Acute Myelogenous ◽

History Of

Abstract Background Elizabethkingia meningosepticum (E. meningosepticum) is a ubiquitous microorganism previously known as Chryseobacterium meningosepticum. It is emerging as a pathogen responsible for bacteremia in immunocompromised patients such as cancer patients especially those with a history of prolonged hospital stay and frequent instrumentations. Methods A retrospective chart review of all cases over 10 years in Moffitt Cancer Center showed a total of three patients with E. meningosepticum infection. Results First patient (history of multiple myeloma) underwent endoscopy complicated by aspiration pneumonia and blood culture positive for E. meningosepticum infection. He was treated with ciprofloxacin, cefoxitin, minocycline and metronidazole and was discharged in stable conditions after 10 days. The second patient (current acute myelogenous leukemia) had neutropenic fever in the setting of recent chest port infection. Blood culture from chest port showed E. meningosepticum and was treated with ciprofloxacin, meropenem and minocycline successfully. The third patient (history of esophageal adenocarcinoma and acute myelogenous leukemia) had history of recent pneumonia and cellulitis who came in with recurrent neutropenic fever. Blood culture was positive for E. meningosepticum and was treated with ciprofloxacin and minocycline. However, the infection was complicated by multiorgan failure and required tracheostomy. As these three cases illustrate, E. meningosepticum bacteremia has high 28- day mortality rate (41%). Conclusion Early identification of the pathogen along with empiric treatment with a fluoroquinolone and/or minocycline is indicated to reduce morbidity and mortality. Disclosures All authors: No reported disclosures.

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