Oral infections and fever in immunocompromised patients with haematologic malignancies

The purpose of the study was to determine the prevalence of acute oral infections and to estimate their role as a possible cause of fever in immunocompromised patients with haematologic malignancies. Seventy-eight febrile episodes in 46 patients were analyzed prospectively and consecutively. An association between a rise in the leukocyte and platelet counts and normalization of the temperature was found. Acute infections were present in 92% of the febrile episodes no infectious cause could be demonstrated in the remaining 8%. Acute oral infections were present during 78% and acute extraoral infections during 73% of the febrile episodes. Acute candidiasis and infected mucosal ulcers were the most prevalent oral infections, occurring in about one-half and one-third of the episodes, respectively. Septicaemia and pneumonia were the most prevalent extraoral infections, each present in about one-fourth of the febrile episodes. Acute oral infections were a probable cause of fever in 14% of the febrile episodes and a possible or a contributing cause of fever in a further 26%. The results suggest that effective treatment or prevention of acute oral infections may reduce the morbidity and perhaps even the mortality in immunocompromised patients.