Should CD4 Levels be Monitored in a Patient on Temozolomide?

  • Sriram Gonakoti John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA
  • Luis Parra-Rodriguez John H Stroger Jr Hospital of Cook County, Chicago, Illinois, USA

Keywords

Temozolomide, non-typhoidal salmonellae, septic arthritis

Abstract

Introduction: Temozolomide is an alkylating agent, indicated in the treatment of refractory anaplastic astrocytoma and newly diagnosed glioblastoma. We describe a case of Salmonella typhimurium bacteraemia associated with septic arthritis in the setting of concurrent temozolomide use.

Case: A 67-year-old woman presented with acute onset of bilateral knee pain and swelling. She had a medical history of glioblastoma multiforme treated with temozolomide. Synovial fluid analysis and blood cultures revealed S. typhimurium, confirming a diagnosis of S. typhimurium bacteraemia associated with septic arthritis.

Conclusion: We conclude that chemotherapy with temozolomide and corticosteroid use will increase an individual’s susceptibility to a wide variety of opportunistic infections akin to HIV-associated acquired immunodeficiency syndrome (AIDS). Furthermore, we hypothesize a possible benefit of monitoring CD4 levels and prophylaxis against opportunistic infections (based on the CD4 levels) in individuals receiving temozolomide-based chemotherapy, similar to HIV-AIDS.

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References

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  • Published: 2021-03-11

    Issue: Vol 8 No 3 (view)

    Section: Articles

    How to cite:
    1.
    Gonakoti S, Parra-Rodriguez L. Should CD4 Levels be Monitored in a Patient on Temozolomide?. EJCRIM 2021;8 doi:10.12890/2021_002276.