Fever and Infection

  • Rasim Gucalp
  • Janice P. Dutcher

Abstract

Despite recent advances in cancer chemotherapy and supportive care, infection is a frequent cause of morbidity and death in patients with cancer, especially those with hematologic malignancies such as leukemia and lymphoma. The frequency and types of infection that occur in patients with cancer depend on the underlying malignancy, the status of the bone marrow, and the status of humoral and cellular immunity. The therapy itself, including drugs, surgery, and radiation, also produces alterations in host defenses and may contribute to the overall risk of infection (Table 1).1

Keywords

Acquire Immune Deficiency Syndrome Neutropenic Patient Central Nervous System Infection Fiberoptic Bronchoscopy Open Lung Biopsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Tattersall MHN: Aggressive cancer treatment and its role in predisposing to infection. Eur J Cancer 11 (Suppl): 9–19, 1975.PubMedGoogle Scholar
  2. 2.
    Pizzo PA, Robichaud KJ, Wesley R, et al: Fever in pediatric and young adult patients with cancer: A prospective study of 1001 episodes. Medicine (Baltimore) 61: 153–165, 1982.Google Scholar
  3. 3.
    The EORTC International Antimicrobial Therapy Project Group: Three antibiotic regimens in the treatment of infection in febrile granulocytopenic patients with cancer. J Infect Dis 137: 14–29, 1978.CrossRefGoogle Scholar
  4. 4.
    Sickles EA, Greene WH, Wiernik PH: Clinical presentation of infection in granulocytopenic patients. Arch Intern Med 35: 715–719, 1975.CrossRefGoogle Scholar
  5. 5.
    Sickles EA, Young VM, Greene WH, et al: Pneumonia in acute leukemia. Ann Intern Med 79: 528–534, 1973.PubMedCrossRefGoogle Scholar
  6. 6.
    Schimpff SC, Wiernik PH, Block JB: Rectal abscesses in cancer patients. Lancet 2: 844–847, 1972.PubMedCrossRefGoogle Scholar
  7. 7.
    Notter DT, Grossman PL, Rosenberg SA, et al: Infections in patients with Hodgkin’s disease: A clinical study of 300 consecutive adult patients. Rev Infect Dis 2: 761–800, 1980.PubMedCrossRefGoogle Scholar
  8. 8.
    Schimpff SC, O’Connell M, Greene WH, et al: Infections in 92 splenectomized patients with Hodgkin’s disease: A clinical review. Am J Med 59: 695–701, 1975.PubMedCrossRefGoogle Scholar
  9. 9.
    Bodey GP, Buckley M, Sathe YS, et al: Quantitative relationship between circulating leucocytes and infection in patients with acute leukemia. Ann Intern Med 64: 328–340, 1966.PubMedCrossRefGoogle Scholar
  10. 10.
    Schimpff SC, Young VM, Greene WH, et al: Origin of infection in acute nonlymphocytic leukemia: Significance of hospital acquisition of potential pathogens. Ann Intern Med 77: 707714, 1972.Google Scholar
  11. 11.
    Albert RK, Condie F: Handwashing pattern in medical intensive care units. N Engl J Med 304: 1465–1466, 1981.PubMedCrossRefGoogle Scholar
  12. 12.
    Newman KA, Schimpff SC, Young VM, et al: Lessons learned from surveillance cultures in patients with acute nonlymphocytic leukemia: Usefulness for epidemiologic, preventive and therapeutic research. Am J Med 70: 423–431, 1981.PubMedCrossRefGoogle Scholar
  13. 13.
    Sanford GR, Merz WG, Wingard JR, et al: The value of fungal surveillance cultures as predictors of systemic fungal infections. J Infect Dis 142: 503–509, 1980.CrossRefGoogle Scholar
  14. 14.
    Bodey GP, Rodriquez V: Advances in management of Pseudomonas aeruginosa infections in cancer patients. Eur J Cancer 9: 435–441, 1973.PubMedGoogle Scholar
  15. 15.
    Bodey GP, Jadeja L, Elting L: Pseudomonas bacteremia: Retrospective analysis of 410 episodes. Arch Intern Med 145: 1621–1629, 1985.PubMedCrossRefGoogle Scholar
  16. 16.
    Wolfson JS, Sober AJ, Rubin RH: Dermatologic manifestations of infections in immunocompromised patients. Medicine (Baltimore) 64: 115–133, 1985.Google Scholar
  17. 17.
    Klastersky J: Concept of empiric therapy with antibiotics combinations: Indications and limits. Am J Med 80 (5C): 2–12, 1986.PubMedGoogle Scholar
  18. 18.
    Pizzo PA, Ladisch S, Simon RM, et al: Increasing incidence of gram positive sepsis in cancer patients. Med Pediatr Oncol 5: 241–244, 1978.PubMedCrossRefGoogle Scholar
  19. 19.
    Wade JC, Schimpff SC, Newman KA, et al: Staphylococcus epidermidis: An increasing cause of infections in patients with granulocytopenia. Ann Intern Med 97: 503–508, 1982.PubMedCrossRefGoogle Scholar
  20. 20.
    Polsky, B, Armstrong D: Infectious complications of neoplastic disease. Am J Infect Control 13: 199–209, 1985.PubMedCrossRefGoogle Scholar
  21. 21.
    Harmon AM, Greene WH: Community acquired infection in hospitalized cancer patients. AM J Infect Control 9: 93, 1981 (abstract).Google Scholar
  22. 22.
    Bodey GP: Antibiotics in patients with neutropenia. Arch Intern Med 144: 1845–1851, 1986.CrossRefGoogle Scholar
  23. 23.
    Moore RD, Smith CR, Lietman PS: The association of aminoglycoside plasma levels with mortality in patients with gram negative bacteremia. J Infect Dis 149: 443–448, 1984.PubMedCrossRefGoogle Scholar
  24. 24.
    Sanders CC, Sanders WE Jr, Goering RV: In vitro antagonism of beta lactam antibiotics by cefoxitin. Antimicrob Agents Chemother 21: 968–975, 1981.CrossRefGoogle Scholar
  25. 25.
    Glauser MP, Neftel KA: Toxicologic and pharmacologic considerations in the choice of empiric parenteral antibiotics. Am J Med 80 (5C): 64–69, 1986.PubMedGoogle Scholar
  26. 26.
    Pizzo PA, Robichaud KJ, Gill FA, et al: Duration of empiric antibiotic therapy in granulocytopenic cancer patients. Am J Med 67: 194–200, 1979.PubMedCrossRefGoogle Scholar
  27. 27.
    Pizzo PA, Robichaud KJ, Gill FA, et al: Empiric antibiotic and antifungal therapy for cancer patients with prolonged fever and granulocytopenia. Am J Med 72: 101–110, 1982.CrossRefGoogle Scholar
  28. 28.
    Dutcher JP: Granulocyte transfusion therapy. Am J Med Sci 287: 13–19, 1984.CrossRefGoogle Scholar
  29. 29.
    Pizzo PA, Ladisch S, Robichaud KJ: Treatment of gram positive septicemia in cancer patients. Cancer 45: 206–207, 1980.PubMedCrossRefGoogle Scholar
  30. 30.
    Press OW, Ramsey PG, Larson EB, et al: Hickman catheter infections in patients with malignancies. Medicine (Baltimore) 63: 189–200, 1984.Google Scholar
  31. 31.
    Reed WP, Newman KA, DeJong C, et al: Prolonged venous access for chemotherapy by means of the Hickman catheter. Cancer 52: 185–192, 1983.PubMedCrossRefGoogle Scholar
  32. 32.
    Stamm WE, Tompkins LS, Wagner KF, et al: Infection due to Corynebacterium species in marrow transplant patients. Ann Interm Med 91: 167–173, 1975.CrossRefGoogle Scholar
  33. 33.
    Shamberger RC, Weinstein HJ, Delorey MJ, et al: The medical and surgical management of typhlitis in children with acute nonlymphocytic (myelogenous) leukemia. Cancer 57: 603–609, 1986.PubMedCrossRefGoogle Scholar
  34. 34.
    Panichi G, Pantosi A, Gentile G, et al: Clostridium difficile colitis in leukemia patients. Eur J Cancer Clin Oncol 21: 1159–1163, 1985.PubMedCrossRefGoogle Scholar
  35. 35.
    Bodey GP, Fainstein V: Infections of the gastrointestinal tract in the immunocompromised patient. Annu Rev Med 37: 271–281, 1986.PubMedCrossRefGoogle Scholar
  36. 36.
    Barnes SG, Sattler FR, Ballard JO: Perirectal infections in acute leukemia: Improved survival after incision and debridement. Ann Intern Med 100: 515–518, 1984.PubMedCrossRefGoogle Scholar
  37. 37.
    Morgan MA, Wilson WR, Neel BH, et al: Fungal sinusitis in healthy and immunocompromised individuals. Am J Clin Pathol 82: 597–601, 1984.PubMedGoogle Scholar
  38. 38.
    Williams DM, Krick JA, Remington JS: Pulmonary infection in the compromised host. Am Rev Respir Dis 116:359–394, 593–627, 1976.Google Scholar
  39. 39.
    Singer C, Armstrong D, Rosen PP, et al: Diffuse pulmonary infiltrates in immunosuppressed patients: Prospective study of 80 cases. Am J Med 66: 110–120, 1979.PubMedCrossRefGoogle Scholar
  40. 40.
    Broaddus C, Dake MD, Stulbarg MS, et al: Bronchoalveoler lavage and transbronchial biopsy for the diagnosis of pulmonary infections in the acquired immunodeficiency syndrome. Ann Intern Med 102: 747–752, 1985.PubMedCrossRefGoogle Scholar
  41. 41.
    Matthay RA, Moritz ED: Invasive procedures for diagnosing pulmonary infection: A critical review. Clin Chest Med 2: 3–18, 1981.PubMedGoogle Scholar
  42. 42.
    Lukes SA, Posner JB, Nielsen S, et al: Bacterial infections of CNS in neutropenic patients. Neurology 34:269–2. 75, 1984.Google Scholar
  43. 43.
    Myerowitz RL, Pazin JG, Allen CM: Disseminated candidiasis: Changes in incidence, underlying diseases, and pathology. Am J Clin Pathol 68: 29–38, 1977.PubMedGoogle Scholar
  44. 44.
    Horn R, Wong B, Kiehn TH, et al: Fungemia in a cancer hospital: Changing frequency, earlier onset and results of therapy. Rev Infect Dis 7: 646–655, 1986.CrossRefGoogle Scholar
  45. 45.
    Cho SY, Choi HY: Opportunistic fungal infection among cancer patients: A ten-year autopsy study. Am J Clin Pathol 72: 617–621, 1979.PubMedGoogle Scholar
  46. 46.
    Maksymiuk AW, Thongprasert S, Hopfer R, et al: Systemic candidiasis in cancer patients. Am J Med 77: 20–27, 1984.PubMedGoogle Scholar
  47. 47.
    Young, RC, Bennett JE, Vogel CL, et al: Aspergillosis: The spectrum of the disease in 98 patients. Medicine (Baltimore) 49: 147–173, 1970.Google Scholar
  48. 48.
    Rinaldi MG: Invasive aspergillosis. Rev Infect Dis 5: 1061–1077, 1983.PubMedCrossRefGoogle Scholar
  49. 49.
    Peterson PK, McGlave P, Ramsay NKC, et al: A prospective study of infectious diseases following bone marrow transplantation: Emergence of aspergillus and cytomegalovirus as the major causes of mortality. Infect Control 4: 81–89, 1983.PubMedGoogle Scholar
  50. 50.
    Feldman S, Hughes WZ, Daniel CB: Varicella in children with cancer: Seventy-seven cases. Pediatrics 56: 388–397, 1975.PubMedGoogle Scholar
  51. 51.
    Balfour HH Jr, Bean B, Laskin OL, et al: Acyclovir halts progression of herpes zoster in immunocompromised patients. N Engl J Med 308: 1448–1453, 1983.PubMedCrossRefGoogle Scholar
  52. 52.
    Onorato IM, Morens DM, Martone WJ, et al: Epidemiology of cytomegaloviral infections: Recommendations for prevention and control. Rev Infect Dis 7: 479–497, 1985.PubMedCrossRefGoogle Scholar
  53. 53.
    Winston DJ, Gale RP, Meyer DV, et al: Infectious complications of human bone marrow transplantation. Medicine (Baltimore) 58: 1–31, 1979.CrossRefGoogle Scholar
  54. 54.
    Hewett TH: Rapid diagnosis of virus diseases. Br Med Bull 41: 315–321, 1985.Google Scholar
  55. 55.
    Meyers JD, Wade JC, Mitchell CD, et al: Multicenter collaborative trial of intravenous acyclovir for treatment of mucocutaneous herpes simplex virus infection in the immunocompromised host. Am J Med 73: 229–235, 1982.PubMedCrossRefGoogle Scholar
  56. 56.
    Ruskin J: Newer developments in diagnosis and treatment of Pneumocystis infections, in Remington JS, Swartz MN (eds): Current Clinical Topics in Infectious Disease. New York, McGraw-Hill, 1986, pp 194–215.Google Scholar
  57. 57.
    Carmelita UT, Delaney MD, Simon GL, et al: Utility of gallium 67 scintigraphy and bronchial washings in the diagnosis and treatment of Pneumocystis carinii pneumonia in patients with the acquired immune deficiency syndrome. Am Rev Respir Dis 132: 1087–1092, 1985.Google Scholar
  58. 58.
    Pizzo PA, Schimpff SC: Strategies for the prevention of infection in the myelosuppressed or immunosuppressed cancer patients. Cancer Treatment Rep 67: 223–234, 1983.Google Scholar
  59. 59.
    Van der Waaj D, Berghuis JM, Lekkerkerk JEC: Colonization resistance of the digestive tract of mice during systemic antibiotic treatment. J Hyg (Cambridge) 70: 605–610, 1972.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1987

Authors and Affiliations

  • Rasim Gucalp
    • 1
  • Janice P. Dutcher
    • 2
    • 3
  1. 1.Department of OncologyMontefiore Medical CenterBronxUSA
  2. 2.Department of Medicine, Division of Medical OncologyAlbert Einstein College of MedicineBronxUSA
  3. 3.Department of OncologyMontefiore Medical CenterBronxUSA

Personalised recommendations