Simultaneous Presentation of B-Acute Lymphoblastic Leukemia and Streptococcus agalactiae Meningitis in a 3-Year-old Girl

• Published in: Journal of pediatric hematology/oncology Vol. 46; no. 6; pp. e448 - e452
• Main Authors: Purvis, Katelyn, Hiskey, Lisa, Khanlari, Mahsa, Mead, Paul E, Holland, Ashley C, Bag, Asim K, Adderson, Elisabeth, Inaba, Hiroto
• Format: Journal Article
• Language: English
• Published: United States 01-08-2024
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bacteremia - drug therapy; Bacteremia - microbiology; Child, Preschool; Dexamethasone - administration & dosage; Dexamethasone - therapeutic use; Female; Humans; Meningitis, Bacterial - diagnosis; Meningitis, Bacterial - drug therapy; Meningitis, Bacterial - microbiology; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - complications; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Streptococcal Infections - drug therapy; Streptococcal Infections - microbiology; Streptococcus agalactiae; Vincristine - administration & dosage; Vincristine - therapeutic use
• ISSN: 1077-4114; 1536-3678; 1536-3678
• DOI: 10.1097/MPH.0000000000002921

Infection is a major cause of treatment-related morbidity and mortality in pediatric acute lymphoblastic leukemia (ALL). Most children with ALL who develop life-threatening bacterial infections do so during induction therapy. We describe a rare case of ALL presenting simultaneously with Streptococcus agalactiae group B Streptococcus bacteremia and meningitis in a 3-year-old girl. She received appropriate antimicrobial therapy and a 2-drug early induction regimen consisting of vincristine and dexamethasone, leading to slow neurologic recovery and a favorable initial response to anti-neoplastic therapy as evidenced by minimal residual disease of 1.12% on day 15 of induction.