Temsirolimus therapy and small bowel perforation in a pediatric patient with Clostridium septicum bacteremia

Temsirolimus has been demonstrated to result in significant disease stabilization in children with high-grade glioma, neuroblastoma, and rhabdomyosarcoma. While mucositis has been reported as a common adverse effect of temsirolimus therapy in adult and pediatric patients, bowel perforation is an infrequent and life-threatening side effect of temsirolimus in adults and has not previously been reported in children. We present a child treated with temsirolimus for recurrent metastatic rhabdomyosarcoma who underwent ileocecectomy and small bowel resection for perforation with frank necrosis. His presentation was complicated by Clostridium septicum infection, a rare, frequently fatal, gastrointestinal pathogen associated with malignancy and bowel ischemia. (C) 2015 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).