title: Clostridial septicemia complicating the course of leukemia.
abstract: The authors report an analysis of 47 leukemia patients (including 9 from our own medical center) whose courses were complicated by 48 episodes of clostridial septicemia. There were 36 adults and 11 children; acute myelogenous leukemia and acute lymphoblastic leukemia accounted for 61.7% and 14.9% of cases, respectively. All patients for whom remission status was known were in leukemic relapse. Fever was a presenting complaint in at least 36 patients whereas neutropenia, thrombocytopenia, and gastrointestinal lesions were noted in 100%, 90.9%, and 87.9%, respectively, of the patients for whom information on these parameters was available. Overall mortality from clostridial septicemia was 78%; none of the children and none of the patients with intravascular hemolysis survived. Overall, antibiotic therapy resulted in a 40% survival rate. However, among patients receiving beta lactam and/or chloramphenicol therapy, 57% survived their episode of clostridial septicemia. Prompt initiation of appropriate antimicrobial therapy offers the best chance of survival in leukemia patients with clostridial septicemia.
authors.forename: J G
authors.initials: JG
authors.lastname: Caya
authors.forename: S G
authors.initials: SG
authors.lastname: Farmer
authors.forename: P S
authors.initials: PS
authors.lastname: Ritch
authors.forename: N J
authors.initials: NJ
authors.lastname: Wollenberg
authors.forename: T M
authors.initials: TM
authors.lastname: Tieu
authors.forename: H W
authors.initials: HW
authors.lastname: Oechler
authors.forename: M
authors.initials: M
authors.lastname: Spivey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003015:Clostridium Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications*; D007945:Leukemia, Lymphoid / Q000150:complications; D015470:Leukemia, Myeloid, Acute / Q000150:complications; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality
chemical_list: D000900:Anti-Bacterial Agents