A Systemic Lupus Erythematosus Patient With Febrile Neutropenia Developing After Intraocular Administration of Bevacizumab
Hamdi SÖZEN1, Gönen MENGİ2, Bülent HÜDDAM3, Selmin ÇAYLAK1, Mehmet DEVEER4, Volkan KARAKUŞ5, Burak Ekrem ÇİTİL6
1Department of Infectious Disease, Medical Faculty of Muğla Sıtkı Koçman University, Muğla, Turkey
2Department of Rheumatology, Medical Faculty of Muğla Sıtkı Koçman University, Muğla, Turkey
3Department of Nephrology, Medical Faculty of Muğla Sıtkı Koçman University, Muğla, Turkey
4Department of Radiology, Medical Faculty of Muğla Sıtkı Koçman University, Muğla, Turkey
5Department of Hematology, Medical Faculty of Muğla Sıtkı Koçman University, Muğla, Turkey
6Department of Microbiology, Medical Faculty of Muğla Sıtkı Koçman University, Muğla, Turkey
Keywords: Bevacizumab, febrile neutropenia, Stenotrophomonas maltophilia, systemic lupus erythematosus
Abstract
In this article, we report a case with febrile neutropenia occurring after implementation of intraocular bevacizumab. A 60-year-old female patient who had received intravitreal bevacizumab applied to hospital for oral lesions accompanying fever and neutropenia. In spite of empiric antibiotherapy, patient’s clinical condition did not improve. Her sputum culture yielded Stenotrophomonas maltophilia. Trimethoprim/ sulfamethoxazole and levofloxacin were commenced according to antibiogram. In immunologic evaluation, antinuclear antibodies and anti-double stranded deoxyribonucleic acid were positive as compatible with systemic lupus erythematosus. After proper antibiotic treatment, patient's clinical symptoms resolved. Development of severe neutropenia after procedures which are not expected to create systemic adverse effects should bring to mind underlying immunosuppressive diseases such as systemic lupus erythematosus.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.