[Septicaemia in leukaemia (author's transl)]

From 244 patients with leukaemia 34 (13,9%) suffered from septicaemia. Although all forms of leukaemia had been concerned, lymphocytic leukaemias (acute and chronic) predominated. Besides other factors, the most important one is the cellular and humoral immuno-deficiency state in this disease. Gram-negative bacteria occur most frequently, followed by staphylococci, streptococci and fungi. The site of origin of infection is rarely known, presumably in most cases the skin, intestinal and genital mucous membranes and the lungs. The clinical picture of septicaemia in leukaemia is not a typical septicaemic one, as the symptoms of the underlying disease predominate. Diagnosis therefore is only based on blood cultures. As therapy is necessary previous to the knowledge of the bacteriological result, it may be initiated by the application of gentamycin (or, in case of resistance, amikacin) combined with ampicillin or chloramphenicol, corrected later in accordance with the antibiogram. High doses of corticosteroids are used specially in shock states. The prevention of septicaemic complications in leukaemia is most important with regard to better results in cytostatic therapy of leukaemias.