[Septicemia in patients with cancer]

Twenty nine patients with the histological diagnosis of cancer and with positive blood cultures are presented. The majority of this group presented tumor activity at the time of developing septicemia. Some of these patients presented a history of recurrent infections. Only 20% of this population had no history of infection preceeding septicemia. The majority of the patients presented leucopenia and thrombocytopenia. All of the patients admitted to the Oncology Unit showed fever but no clinical evidence of the site of the infection. Several cultures were made but the patients were started at once on systemic antibiotics. The antibiotic combination used in every case was freely selected according with the physician's criteria; however, six patients were not treated with antibiotics and died. There was a definitive predominance of gram-negative blood cultures. The mortality in this group was 68% and was secondary to three main factors: those patients which were not treated with any antibiotic; granulocitopenia and inadequate selection of the antibiotic used in some of the patients. Pertinent literature regarding infection and cancer was reviewed, including the cause/effect of chemotherapy, radiotherapy and surgery, as well as other factors, such as the immunosuppression produced by the malignant disease. Emphasis is placed on the usage of prophylactic antibiotics in patients with cancer, neutropenia and fever of unknown origin.