title: Nature and outcome of febrile episodes in patients with pancreatic and hepatobiliary cancer.
abstract: Fifty febrile episodes in patients with hepatobiliary and pancreatic cancer were reviewed. Biliary obstruction often resulting in cholangitis was an important predisposing factor, whereas neutropenia (< 500 PMN/mm3) was uncommon (10%). Microbiologically documented infections originating from the gastrointestinal tract were predominant, with Enterococcus faecalis and Escherichia coli being isolated most often. Non-infectious causes of fever occurred in 16% of patients. Only one patient developed a fungal infection. The overall response rate to therapy was 94%, with 32% being eligible for outpatient management. These data are quite different from those generated from patients with hematologic malignancies and indicate that disease-site specific management guidelines need to be developed for febrile episodes in patients with various underlying neoplasms.
authors.affiliation: Department of Medical Specialities, University of Texas, M.D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: K V
authors.initials: KV
authors.lastname: Rolston
authors.forename: N
authors.initials: N
authors.lastname: Dholakia
authors.forename: S
authors.initials: S
authors.lastname: Rodriguez
authors.forename: E B
authors.initials: EB
authors.lastname: Rubenstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001661:Biliary Tract Neoplasms / Q000150:complications*; D015984:Causality; D002779:Cholestasis / Q000150:complications; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007239:Infections / Q000188:drug therapy / Q000209:etiology*; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications; D010190:Pancreatic Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents