Nature and outcome of febrile episodes in patients with pancreatic and hepatobiliary cancer.
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.
Rolston
K V
KV
Department of Medical Specialities, University of Texas, M.D. Anderson Cancer Center, Houston 77030, USA.
Dholakia
N
N
Rodriguez
S
S
Rubenstein
E B
EB
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
D000900:Anti-Bacterial Agents