Septicemia in childhood malignancy. Analysis of 101 consecutive episodes.
One hundred one consecutive episodes of blood-culture-positive infection were evaluated in 83 children with malignancy between 1972 and 1977. Eighty-two per cent occurred in relapse, and 75% developed when the absolute neutrophil count was less than 500 per microliters. Forty per cent were fatal. Forty-five per cent of the episodes occurring in relapse and 17% occurring in remission were fatal. Of 88 cases of single-organism infection, 46% were due to gram-positive organisms with a 13% mortality (of these, 28% were due to Staphylococcus aureus with a 4% mortality); 52% were due to gram-negative organisms with a 52% mortality; and two episodes were due to fungal organisms with no fatalities. Multiple-organism infection occurred 13 times, of which 11 episodes were fatal. The authors' data confirm observations by others that the organisms most commonly causing blood-culture-positive infection in children with malignancy are S. aureus and Escherichia coli and that infection due to gram-positive organisms, particularly S. aureus, is less than frequency fatal.
D004927:Escherichia coli Infections / Q000209:etiology*; D006801:Humans; D007938:Leukemia / Q000150:complications; D007958:Leukocyte Count; D008223:Lymphoma / Q000150:complications; D009369:Neoplasms / Q000150:complications*; D009504:Neutrophils; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology*; D013203:Staphylococcal Infections / Q000209:etiology*