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Ulcerated Rhabdomyosarcoma as Portal of Entry for Tetanus in a Previously Nonimmunized Child

Odone-Filho, Vicente MD; Almeida, Maria T A MD; Bakhit, Salma MD; Maluf, Paulo T Jr. MD; Peron, Paula P D MD; Aquino, Maria Z MD; Cristofani, Lilian M MD

Journal of Pediatric Hematology/Oncology: April 2005 - Volume 27 - Issue 4 - p 227-228
doi: 10.1097/01.mph.0000158534.98025.25
Clinical and Laboratory Observations
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Infectious diseases represent one of the most important secondary problems related to the treatment of childhood cancer, being the leading cause of death in this population. They are predominantly of bacterial and fungal etiology. The association between tetanus, a bacterial vaccine-preventable disease, and cancer is virtually undescribed. The authors present the case of a previously nonimmunized child, due to his parents' choice, who developed severe tetanus with an ulcerated rhabdomyosarcoma as portal of entry. Due to an unfavorable evolution, the child underwent a hip disarticulation to provide tetanus control. The ulterior tumor management was successful: the child has been off therapy for more than 108 months with no evidence of disease.

From the Instituto de Tratamento do Câncer Infantil, Instituto da Criança, Departamento de Pediatria da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Received for publication November 9, 2004; accepted January 24, 2005.

Reprints: Vicente Odone-Filho, Oncology Unit, Instituto de Tratamento do Câncer Infantil, Instituto da Criança, Departamento de Pediatria da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho de Aguiar, 647, 05403-900, São Paulo, SP Brazil (e-mail: odone@uol.com.br or vicenteof@icr.hcnet.usp.br).

© 2005 Lippincott Williams & Wilkins, Inc.