Septicemic complications of the cutaneous T-cell lymphomas

The records of 60 consecutive patients with cutaneous T-cell lymphomas were reviewed to determine the incidence, etiology, predisposing factors, therapy, complications and outcome of septicemia. Fourteen (23 percent) patients had 26 septicemias: due to gram-positive cocci in 21 and to gram-negative bacilli in five. The presence of stage IV lymphomatous disease (p 0.032), generalized erythroderma (p less than 0.001), palpable lymph nodes (p 0.014), and histologic involvement of lymph nodes (p 0.023) and peripheral blood (p less than 0.001) identified a subset of patients at high risk for sepsis. Sepsis was correlated with locally infected sites in 77 percent of the episodes. Single antimicrobial therapy was successful in all septicemias due to gram-positive cocci but was accompanied by five secondary gram-negative bacillary superinfections (80 percent fatal). The subsequent mortality in all patients who survived infection (50 percent) indicated their poor over-all prognosis.