Chemotherapy-associated oral infections in adults with solid tumors

The frequency of chemotherapy-associated oral infections in adult inpatients with solid tumors was determined in 825 subjects with carcinoma, 60 with sarcoma, and 115 with lymphoma. The total number of documented oral infections in the 1,000 patients was 97 (9.7 percent), with frequency rates of 8.4 percent, 11.7 percent, and 18.3 percent for the patients with carcinoma, sarcoma, and lymphoma, respectively. All but six of the infections were caused by a single organism. Microbiologically, 68.9 percent of the infections were ascribable to fungi, 10.7 percent to gram-negative bacilli, 10.7 percent to herpes simplex, and 9.7 percent to gram-positive cocci. The patients with solid tumors were less than one third as prone to oral infections as adults with acute leukemia treated in the same hospital. Among the solid tumor group, those with lymphoma were almost twice as likely to develop infections of the mouth during chemotherapy as those with carcinoma or sarcoma. The oral infection experience in the previously reported patients with acute leukemia and in the present series of patients with solid tumors strongly suggests that the more aggressive the malignancy and the more potent the chemotherapy, the greater the tendency to stomatologic infections.