title: [Fatal bone marrow necrosis and fat embolism following sepsis in a patient with acute lymphoblastic leukemia after consolidation chemotherapy].
abstract: We report a 58-year-old Japanese man with acute lymphoblastic leukemia. On the seventh day of his second course of consolidation therapy, he developed herpes zoster, and on the 17th day, he developed a high fever, dyspnea, and lapsed into a coma. Streptococcus constellatus was isolated from blood culture. Despite intensive therapy, multiple organ failure progressed rapidly, and he died on the 19th day. Pathological examination of autopsy specimens revealed bone marrow necrosis and fat embolism in multiple organs. In this patient, sepsis led to bone marrow necrosis and, subsequently, to fat embolism.
authors.affiliation: Nagano Red Cross Hospital, Department of Hematology.
authors.forename: Wataru
authors.initials: W
authors.lastname: Takeda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sumi
authors.forename: Takehiko
authors.initials: T
authors.lastname: Kirihara
authors.forename: Taro
authors.initials: T
authors.lastname: Kurihara
authors.forename: Keijiro
authors.initials: K
authors.lastname: Sato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Fujikawa
authors.forename: Ikuo
authors.initials: I
authors.lastname: Shimizu
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Ueki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hiroshima
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ueno
authors.forename: Naoaki
authors.initials: N
authors.lastname: Ichikawa
authors.forename: Masahide
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology*; D060830:Consolidation Chemotherapy / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004620:Embolism, Fat / Q000209:etiology*; D017809:Fatal Outcome; D006562:Herpes Zoster / Q000209:etiology; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D009336:Necrosis / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D018805:Sepsis / Q000209:etiology*; D013290:Streptococcal Infections / Q000209:etiology*; D034365:Streptococcus constellatus; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide