In neutropenic cancer patients, infection can present with no typical signs and
symptoms but fever. The lack of granulocyte often makes the inflammatory signs of
infection incospicuous. In addition, infection in neutropenic patients can often present as
fulminant process.
So, early initiation of empiric antibiotic therapy in febrile cancer patients has become
established practice.
We retrospectively studied 110 episodes of fever and granulccytopenia in patients with
leukemia or solid tumor who were admitted to the department of pediatrics at the
Yeungnam University hospital from may, 1983 to september, 1989. Fifteen cases of
sepsis among these patients were evaluated.
Incidence of sepsis in these patients was 13.6% and presence of shock was 26% at
presentation. E.coli(47%) and staphylococcus aureus(20%) were two most common
agents, isolated from the blood cultures of the patients.E.coli was more sensitive to
amikin than gentamicin and staphylococcus aureus was sensitive to methicillin and
cephalothin.
Overall mortality rate of sepsis was 20%.
We concluded in this study that combination of amikacin and 3rd generation
cephalosporin was recommended for septic cancer patients with neutropenia as first line
drug, Futhermore azactam (aztreonam ) and vancomycin was recommended according to
the results of the blood culture and its sensitivity or the clinical course of the patient.
|