The purpose of our study was to highlight the importance of considering live vaccines as a source of bacteremia and viremia when used as therapy in cancer patients. We present 2 cases, one with pancreatic cancer who received live-attenuated Listeria monocytogenes vaccine and another one with Glioblastoma Multiforme who received live Adenovirus vaccine.
Our first patient was a 67-year-old female with locally advanced, unresectable pancreatic cancer who was started on therapy with live-attenuated Listeria monocytogenes vaccine. She presented to our facility with a chief complaint of fever, headaches, diarrhea and abdominal pain. Her blood cultures grew Listeria monocytogenes despite taking prophylactic oral ampicillin after live vaccine infusion 2 months prior. She was treated successfully with intravenous ampicillin leading to resolution of symptoms as well as bacteremia.
Our second patient is a 58-year-old male patient with a history of recurrent glioblastoma multiforme despite chemoradiation. He received intra-lesional Adenovirus injection 2 weeks before admission. He was admitted to our facility with a 1 week history of fever, fatigue, nausea, vomiting as well as 2 days of altered mental status. CSF analysis showed 290 leukocytes with a lymphocyte predominance, CSF PCR and blood PCR were positive for Adenovirus with more than 10 million copies in CSF. He improved back to his baseline mentation without fever 2 weeks later. He did not receive antiviral therapy.
S. Nanjappa, None
J. Greene, None