title: Listeria brain abscess, Pneumocystis pneumonia and Kaposi's sarcoma after temozolomide.
abstract: BACKGROUND
  A 55-year-old man with glioblastoma multiforme was treated with continuous, dose-dense temozolomide. This therapy was curtailed after three cycles because of nausea, asthenia, and neuropsychological deterioration. During a subsequent course of radiotherapy, the patient developed fever, headaches, and cutaneous lesions.
  
  
  METHODS
  Physical examination, cerebral MRI, brain biopsy, skin biopsy, immunohistochemistry, bronchoscopy with bronchoalveolar lavage, and laboratory tests.
  
  
  METHODS
  Severe temozolomide-induced immunosuppression, exacerbated by corticosteroids, with profound T-cell lymphocytopenia and simultaneous opportunistic infections with Pneumocystis jiroveci pneumonia, brain abscess with Listeria monocytogenes, and cutaneous Kaposi's sarcoma.
  
  
  RESULTS
  Discontinuation of temozolomide, discontinuation of radiotherapy, antibiotic treatment with amoxicillin and gentamicin, and administration of atovaquone and pentamidine.
authors.affiliation: University of Lausanne Hospitals, Lausanne, Switzerland.
authors.forename: Vincent
authors.initials: V
authors.lastname: Ganière
authors.forename: Grégoire
authors.initials: G
authors.lastname: Christen
authors.forename: Frank
authors.initials: F
authors.lastname: Bally
authors.forename: Louis
authors.initials: L
authors.lastname: Guillou
authors.forename: Alessia
authors.initials: A
authors.lastname: Pica
authors.forename: Sandrine
authors.initials: S
authors.lastname: de Ribaupierre
authors.forename: Roger
authors.initials: R
authors.lastname: Stupp
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D001922:Brain Abscess / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000601:surgery; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives*; D005909:Glioblastoma / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008088:Listeriosis / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000139:chemically induced* / Q000188:drug therapy; D012514:Sarcoma, Kaposi / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide