Ruptured Klebsiella pneumoniae liver abscess after high-dose cyclophosphamide for severe aplastic anemia.
A 19-year-old woman with severe aplastic anemia who had previously failed antithymocyte globulin/cyclosporine A received high-dose cyclophosphamide without bone marrow rescue. On day +14, she complained of right upper quadrant abdominal pain and fever. A CT scan of the abdomen showed multiple liver abscesses with rupture and Klebsiella pneumoniae was isolated from blood. In spite of aggressive antibiotic therapy, she rapidly deteriorated and died of overwhelming sepsis. To our knowledge, our patient is the first case of fatal ruptured liver abscess after high-dose cyclophosphamide in a patient with severe aplastic anemia.
Lee
J J
JJ
Blood and Marrow Transplant Program, Chonnam National University Medical School, Kwangju, Korea.
Kim
H J
HJ
Chung
I J
IJ
Kook
H
H
Park
M R
MR
Kim
C J
CJ
Shin
D H
DH
Hwang
T J
TJ
D000328:Adult; D000741:Anemia, Aplastic / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007710:Klebsiella Infections; D007711:Klebsiella pneumoniae; D008100:Liver Abscess / Q000209:etiology*; D012422:Rupture, Spontaneous / Q000139:chemically induced
D003520:Cyclophosphamide