[Febrile neutropenia caused by diphteroids--report of 14 cases]

The last few years have withnessed the significant increase of febrile neutropenias caused by diphteroids. In fact, with the development of bacterologically protected units, saprophytic bacteria--including diphteroids 0 became increasingly important in the aethiology of febrile neutropenias. Over the period from April 1986 to December 1992, in the bacteriologically protected unit of the Institute, 14 diphteroids were isolated from blood cultures in 14 patients with neoplastic disorders (12 males and 2 females), aged 24-70 years (median 44 years) treated with aggressive chemotherapy. The number of chemotherapy cycles prior to development of febrile neutropenias caused by diphteroids varied from 3 to 11 with the median of 8 cycles. The granulocytes range on the first day of fever was between 0.0-1.1 x 10(9)/l with a median count of 0.3 x 10(9)/l. The duration of fever was between 2-10 days with the median of 4 days. The fever never exceeded 38.5 degrees C. The initial antibiotherapy, predominantly a combination of cephalosporines and aminoglicosides (applied before blood culture results were available), was effective in almost all cases. In relation to all blood culture isolates from patients with febrile neutriopenias, diphteroids, mainly Corynebacterium pseudodiphtericum, constitute 3.22% in our material. As literature data point to the emergeny of new virulent and multiresistant groups, the exact identification of diphteroids from blood cultures is warranted.