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一名晚期乳腺外佩吉特病患者在接受多西他赛化疗后出现艰难梭菌结肠炎和中性粒细胞减少性发热。

Clostridium difficile Colitis and Neutropenic Fever Associated with Docetaxel Chemotherapy in a Patient with Advanced Extramammary Paget's Disease.

作者信息

Nonomura Yumi, Otsuka Atsushi, Endo Yuichiro, Fujisawa Akihiro, Tanioka Miki, Kabashima Kenji, Miyachi Yoshiki

机构信息

Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

Case Rep Dermatol. 2012 May;4(2):177-80. doi: 10.1159/000342069. Epub 2012 Aug 22.

Abstract

Extramammary Paget's disease is a rare cutaneous malignant neoplasm. Previous studies indicated the efficacy of docetaxel in advanced cases. The common side effects of docetaxel are usually tolerable and seldom life-threatening. We experienced a case of severe pseudomembranous colitis and neutropenic fever that developed just after the first cycle of docetaxel chemotherapy. To the best of our knowledge, there are few reports of pseudomembranous colitis associated with docetaxel administration for skin cancers. The patient showed complete resolution of her symptoms within 2 weeks with an oral metronidazole therapy. During the second and third cycles, the patient received docetaxel safely with lower doses. The present case indicated that pseudomembranous colitis should be included in the differential diagnosis when assessing patients who develop severe diarrhea during systemic chemotherapy with docetaxel.

摘要

乳腺外佩吉特病是一种罕见的皮肤恶性肿瘤。既往研究表明多西他赛对晚期病例有效。多西他赛的常见副作用通常可以耐受,很少危及生命。我们遇到一例在多西他赛化疗的第一个周期后就发生严重伪膜性结肠炎和中性粒细胞减少性发热的病例。据我们所知,很少有关于多西他赛用于皮肤癌治疗而导致伪膜性结肠炎的报道。该患者经口服甲硝唑治疗后,症状在2周内完全缓解。在第二和第三个周期,患者以较低剂量安全地接受了多西他赛治疗。本病例表明,在用多西他赛进行全身化疗时,评估出现严重腹泻的患者时,应将伪膜性结肠炎纳入鉴别诊断。

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