MRSA-pyomyositis in a Patient with Acute Myelogenous Leukemia after Intensive Chemotherapy

• Published in: Anticancer research 2009-08, Vol.29 (8), p.3361-3364
• Main Authors: FUKUSHIMA, Toshihiro, IWAO, Haruka, NAKAZIMA, Akio, MIKI, Miyuki, SAKAI, Tomoyuki, SAWAKI, Toshioki, TANAKA, Masao, MASAKI, Yasufumi, HIROSE, Yuko, UMEHARA, Hisanori
• Format: Article
• Language: English
• Subjects: Abscess - diagnosis; Abscess - drug therapy; Abscess - etiology; Anti-Infective Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Dibekacin - analogs & derivatives; Dibekacin - therapeutic use; Diseases of striated muscles. Neuromuscular diseases; Fever - prevention & control; Humans; Immunocompromised Host; Leukemia, Myeloid, Acute - complications; Leukemia, Myeloid, Acute - drug therapy; Leukemia, Myeloid, Acute - microbiology; Male; Medical sciences; Methicillin Resistance; Methicillin-Resistant Staphylococcus aureus - pathogenicity; Middle Aged; Neurology; Pyomyositis - diagnosis; Pyomyositis - drug therapy; Pyomyositis - etiology; Remission Induction; Staphylococcal Infections - diagnosis; Staphylococcal Infections - drug therapy; Staphylococcal Infections - etiology; Staphylococcus aureus; Tumors
• ISSN: 0250-7005; 1791-7530

Background: A case of methicillin-resistant Staphylococcus aureus (MRSA)-pyomyositis in association with acute myelogenous leukemia (AML) is reported. MRSA-sepsis developed in a 51-year-old Japanese man with AML, during the neutropenic period after high-dose 1-β- d -arabinofuranosylcytosine (Ara-C). Although the MRSA-sepsis initially improved with arbekacin sulfate (ABK) administration, a high fever recurred with left thigh pain despite recovery of the neutrophil count after ABK was stopped. A computed tomographic (CT) scan showed a low-density area in the left quadriceps femoris muscle, which led to a diagnosis of pyomyositis. MRSA was cultured from the abscess aspirates. The fever and thigh pain disappeared after administration of ABK and minocycline hydrochloride (MINO), and the abscess completely disappeared with the oral administration of levofloxacin (LVFX) for about 3 months. Conclusion: If an immunocompromised patient complains of fever and muscle pain after intensive chemotherapy, MRSA-pyomyositis should be considered.