Accidental intrathecal administration of bleomycin: favorable outcome after pneumo-encephalus and cerebrospinal fluid exchange: a case report.
Bleomycin is generally used as an antineoplastic drug for the intravenous treatment of germ cell tumors or lymphomas. Due to its toxic effect on epithelial cells bleomycin is also used for the treatment of malignant pleural or pericardial effusions. Inadvertent intrathecal administration of cytotoxic drugs may occur due to increasingly complex therapeutic protocols, even when control mechanisms are applied. We report the case of a 39-year-old man with chronic myeloid leukemia. During the treatment of a lymphoblast crisis 30 mg of bleomycin were inadvertently injected intrathecally. Prompt cerebrospinal fluid exchange, dilution with normal saline, and corticosteroid treatment resulted in a positive outcome without major side effects.
Loebermann
Micha
M
Kahl
Christoph
C
Steiner
Beate
B
Hartung
Gernot
G
Freund
Mathias
M
D000305:Adrenal Cortex Hormones / Q000494:pharmacology; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects / Q000134:cerebrospinal fluid; D001761:Bleomycin / Q000008:administration & dosage* / Q000009:adverse effects / Q000134:cerebrospinal fluid; D002555:Cerebrospinal Fluid / Q000378:metabolism*; D004679:Encephalomyelitis / Q000139:chemically induced / Q000628:therapy; D006801:Humans; D007278:Injections, Spinal; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008508:Medication Errors; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000903:Antibiotics, Antineoplastic; D001761:Bleomycin