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Transient bacteraemia secondary to imiquimod use as a treatment for cervical high-grade squamous intraepithelial

Caroline L P Muntinga1,2, Sophieke C H A van der Steen3, Edith M G van Esch1

  • 1Department of gynecology and obstetrics, Catharina Ziekenhuis Eindhoven, Michelangelolaan 2, 5623 EJ Eindhoven, the Netherlands.

Case Reports in Women'S Health
|March 4, 2025
PubMed

Insights

Imiquimod cream for cervical lesions can cause severe side effects like distributive shock. Patients require close monitoring for adverse reactions during treatment for high-grade squamous intraepithelial lesions.

Area of Science:

  • Gynecologic Oncology
  • Dermatology
  • Pharmacology

Background:

  • Imiquimod is an immunomodulator used for cervical high-grade squamous intraepithelial lesions (cHSIL).
  • While generally well-tolerated, imiquimod can cause significant side effects.
  • Patient counselling regarding potential adverse events is crucial.

Observation:

  • A patient using imiquimod for recurrent cHSIL developed distributive shock.
  • The severe reaction occurred nearly three weeks after initiating treatment.
  • No infectious etiology was identified for the patient's condition.

Findings:

  • The patient recovered with conservative management.
  • This case highlights the potential for severe, unexpected side effects from imiquimod.
  • Distributive shock is a rare but serious adverse event associated with imiquimod therapy.

Implications:

  • Healthcare providers must vigilantly monitor patients undergoing imiquimod treatment for cHSIL.
  • Informed consent discussions should thoroughly cover the risk of severe side effects.
  • Further research may be warranted to identify risk factors for severe imiquimod reactions.

Keywords:
Case reportCervical HSILHPVImiquimodImmunologySide-effects

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