Multiple opportunistic infections after high-dose steroid therapy for giant cell arteritis in a patient previously treated with a purine analog

Scand J Infect Dis. 2006;38(10):922-4. doi: 10.1080/00365540500540475.

Abstract

We present the case of a 74-y-old HIV-negative female who suffered simultaneously from multiple opportunistic infections and a Klebsiella pneumoniae sepsis during high-dose steroids for giant cell arteritis. The patient was treated with a purine analog due to hairy cell leukaemia 10 y previously. Purine analog therapy can lead to long lasting defects in cell-mediated immunity. In these patients, treatment with steroids should be closely monitored with CD4 counts.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amphotericin B / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use
  • Antifungal Agents / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Aspergillosis / chemically induced
  • Aspergillosis / diagnosis
  • Aspergillosis / pathology
  • Cladribine / adverse effects*
  • Cytomegalovirus / isolation & purification
  • Dexamethasone / administration & dosage*
  • Dexamethasone / adverse effects*
  • Dexamethasone / therapeutic use
  • Esophagitis / chemically induced
  • Esophagitis / virology
  • Female
  • Giant Cell Arteritis
  • Herpes Simplex / chemically induced
  • Humans
  • Klebsiella Infections / chemically induced
  • Klebsiella Infections / diagnosis
  • Klebsiella Infections / pathology
  • Klebsiella pneumoniae / isolation & purification
  • Leukemia, Hairy Cell
  • Methylprednisolone / administration & dosage*
  • Methylprednisolone / adverse effects*
  • Methylprednisolone / therapeutic use
  • Opportunistic Infections / chemically induced*
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / microbiology
  • Pneumocystis carinii / isolation & purification
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Antifungal Agents
  • Antineoplastic Agents
  • Cladribine
  • Dexamethasone
  • Amphotericin B
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Methylprednisolone