[Serious bacterial infections in patients with hematologic disorders]

In patients with hematologic disorders, especially, leukemias and lymphomas, complicated bacterial infection frequently becomes serious. Main predisposing factors are (1) the disease and its chemotherapy (2) granulocytopenia and (3) mucosal damage. The site of infection is often unidentified. Two special sites, the oral cavity and central venous catheter, should not be overlooked. The infection is usually treated by empiric therapy. G-CSF is effective for rapid granulocyte recovery. For prophylaxis, the laminar air flow room, oral nonabsorbable antibiotics, and systemic chemoprevention with colonization resistance are recommended. Noteworthy among recent infections are (1) MRSA infection caused by long-term use of third generation cephems and (2) neutropenic enterocolitis, for which the most recommended aid is surgical resection of the lesion.