title: Fever and infection in leukemic patients: a study of 494 consecutive patients.
abstract: All of the febrile episodes occurring in 494 adults with acute leukemia were reviewed. There were an average of 2.39 febrile episodes per patient and the patients spent 28% of their days in the hospital with fever. Sixty-four percent of the febrile episodes were due to infection. The most common types of infection  were disseminated infection and pneumonia, which together accounted for 69% of the total episodes of documented infection. The etiologic agent was identified in 73% of the documented infections and gram-negative bacilli were responsible for the great majority. The most common gram-negative bacilli causing infection were Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa. During the course of their leukemia, 31% of the patients had repeated episodes of infection caused by the same organism and 13% ahd repeated FUO's. Fever occurred most often when the patients had neutropenia (less than 500/mm3). The fatality rate from septicemia decreased from 84% in 1966 to 44% in 1972. The fatality rate for major infections caused by gram-positive cocci was 16%, for gram-negative bacilli was 37% and for fungi was 86%. Although infection remains a serious problem in leukemia patients, considerable progress has been made.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D004927:Escherichia coli Infections / Q000150:complications; D005260:Female; D005334:Fever / Q000097:blood / Q000209:etiology*; D005335:Fever of Unknown Origin / Q000150:complications; D006801:Humans; D007239:Infections / Q000150:complications* / Q000401:mortality; D007710:Klebsiella Infections / Q000150:complications; D007938:Leukemia / Q000150:complications*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications; D009504:Neutrophils; D011014:Pneumonia / Q000150:complications; D011552:Pseudomonas Infections / Q000150:complications; D012008:Recurrence; D013203:Staphylococcal Infections / Q000150:complications