title: Rapidly fatal acute bacterial myocarditis in a nonneutropenic child with acute lymphoblastic leukemia in remission.
abstract: The authors report a fatal case of acute bacterial myocarditis in a nonneutropenic child with acute lymphoblastic leukemia. She was admitted to the hospital with a urinary tract infection resulting from and remained persistently febrile despite resolution of the infection. On hospital day 4 signs of acute cardiac failure developed. Despite aggressive resuscitation measures, she died. Pathologic examination revealed the cause of death to be bacterial myocarditis. In addition, she was found to have a generalized decrease in her serum immunoglobulin levels. Acute bacterial myocarditis in patients with malignancy has been rarely reported. The rapid clinical deterioration and death in the patient in this report is particularly interesting.
authors.affiliation: Department of Pediatrics, Division of Hematology/Oncology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390-9063, USA. Douglas.Scothorn@UTSouthwestern.edu
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Scothorn
authors.forename: Naomi J
authors.initials: NJ
authors.lastname: Winick
authors.forename: Charles F
authors.initials: CF
authors.lastname: Timmons
authors.forename: Victor M
authors.initials: VM
authors.lastname: Aquino
mesh_terms: D000208:Acute Disease; D000361:Agammaglobulinemia / Q000150:complications; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D002648:Child; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007710:Klebsiella Infections / Q000188:drug therapy / Q000209:etiology*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D009205:Myocarditis / Q000209:etiology* / Q000382:microbiology; D010068:Oxacillin / Q000627:therapeutic use; D010493:Pericarditis / Q000209:etiology / Q000382:microbiology; D010998:Pleurisy / Q000209:etiology / Q000382:microbiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D012074:Remission Induction; D020069:Shoulder Pain / Q000209:etiology; D014031:Tobramycin / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000150:complications / Q000382:microbiology
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D002439:Cefotaxime; D010068:Oxacillin; D014031:Tobramycin