Unnikrishnan Girija Manush1, Praveen Malayath2, Abdul Majeed Kuruvadangal3
BACKGROUND
Infection is a major cause of morbidity and mortality in patients receiving chemotherapy for acute leukaemias. This is an attempt to study oropharyngeal, respiratory and skin infections in patients with acute leukaemia receiving chemotherapy with reference to their aetiology, response to antimicrobial treatment and relation with neutropenia.
MATERIALS AND METHODS
All acute leukaemic patients on chemotherapy with any clinical or laboratory features of oropharyngeal, respiratory tract or skin infections admitted in the Haematology Unit of Calicut Government Medical College were included in the study. In the present study, a total of 70 febrile episodes were studied. These episodes were investigated for infectious aetiology by putting appropriate specimen(s) for culture/microscopy for bacterial, fungal and parasitic agents.
RESULTS
Maximum incidence of infections and the poorest outcome was observed when absolute neutrophil count was <500. Incidence of severe neutropenia in our study was 42.86% with high mortality in severely neutropenics (40%). Respiratory system was the commonest site of infection (54%). Pyogenic bacteria were predominating in the culture studies with 21 cultures positive. Staphylococcus aureus (47.61%) was the commonest agent in the culture samples.
CONCLUSION
Rate of neutropenia as well as mortality is high in AML patients when comparing with ALL. Most common symptom indicating infection is fever even if the patient is having defective immunity. Thrombophlebitis at intravenous cannula site is a common focus of infection. Majority of patients responded well to first line antibiotics, even though culture and sensitivity studies were negative.
