Causes of fever in cancer patients (prospective study over 477 episodes).
OBJECTIVE
The aim of this study was to determine the causes of fever among cancer patients.


METHODS
All febrile cancer patients were followed up prospectively. Clinical, microbiological and radiological documentations were performed. Aetiologies of fever, type of tumour, site of infection, type of microorganism and outcome were assessed and compared between neutropenics and non-neutropenics.


RESULTS
Four hundred and seventy-seven episodes were evaluated. Infection, non-infectious causes and fever of unknown origin represented 67, 23 and 10%, respectively. The respiratory tract is the most frequently involved site in infection (29%), and in microbiologically documented infections, Gram-negative bacilli were predominant. The tumour itself (27%) or an invasive procedure (17%) were the main causes of non-infectious febrile episodes. Mortality from infection was higher among non-neutropenic (11.1%) than neutropenic patients (4.3%).


CONCLUSIONS
Fever in cancer patients remains a challenge, and the differentiation between infectious and non-infectious causes at onset of fever is very difficult. Despite all the prophylactic measures, infection is still the principal cause. However, the infection-related mortality is low either in neutropenic or non-neutropenic patients.
Toussaint
E
E
Laboratoire de Microbiologie et Département des Maladies Infectieuses, Institut Jules Bordet, rue Héger-Bordet 1, 1000 Bruxelles, Belgium. nathalie.cardinal@bordet.be
Bahel-Ball
E
E
Vekemans
M
M
Georgala
A
A
Al-Hakak
L
L
Paesmans
M
M
Aoun
M
M
D001530:Belgium / Q000453:epidemiology; D005334:Fever / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D005500:Follow-Up Studies; D016905:Gram-Negative Bacterial Infections / Q000150:complications; D006801:Humans; D007239:Infections / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology; D009503:Neutropenia / Q000150:complications / Q000453:epidemiology; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications; D015996:Survival Rate