Ibrutinib-associated necrotic nasal lesion and pulmonary infiltrates

BMJ Case Rep. 2021 Jan 19;14(1):e237085. doi: 10.1136/bcr-2020-237085.

Abstract

Herein, we report a case of a 68-year-old woman receiving ibrutinib for chronic lymphocytic leukaemia, who presented with septic shock and a progressive necrotic lesion on her nose. Surgical pathology of the nasal lesion revealed evidence of tissue necrosis, and both tissue and blood culture grew Pseudomonas aeruginosa A diagnosis of ecthyma gangrenosum was made. Additional investigations also led to the discovery of invasive pulmonary aspergillosis. To our knowledge, this is the first case of ecthyma gangrenosum secondary to Pseudomonas sepsis and concurrent invasive pulmonary aspergillosis associated with ibrutinib use.

Keywords: dermatology; infections; infectious diseases; malignant disease and immunosuppression.

Publication types

  • Case Reports

MeSH terms

  • Adenine / adverse effects
  • Adenine / analogs & derivatives*
  • Aged
  • Ecthyma / diagnosis*
  • Ecthyma / etiology*
  • Female
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Necrosis
  • Piperidines / adverse effects*
  • Pseudomonas Infections / diagnosis*
  • Pseudomonas Infections / etiology
  • Pseudomonas aeruginosa*
  • Sepsis / diagnosis
  • Sepsis / etiology

Substances

  • Piperidines
  • ibrutinib
  • Adenine