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[Afebrile infections in adult patients with acute leukemia]
A Brodsky1, M Melero, C J Minissale
1Departamento de Medicina, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
Abstract:
Characteristics of afebrile infection episodes among adult patients with acute leukemia are here described. Afebrile episodes represented 14.3% of all infections. They significantly differed from the febrile episodes because: 1) they prevailed among patients with granulocyte count greater than 500/mm3 (p < 0.001); 2) they often involved patients in complete remission (p < 0.0002); 3) they affected more frequently the kidney and urinary tract than febrile infections (p = 0.0005) and 4) they lacked lung involvement (p < 0.01). The rate of documented infections by cultures, cytology or serological tests was not different between both infection types. Observed mortality during afebrile episodes was threefold less than febrile infections; this difference, however, did not reach statistical significance. In conclusion, afebrile infection in acute leukemia is a distinct clinical entity, unlike febrile infection.
Insights
Afebrile infections in acute leukemia patients are distinct, occurring more in those with higher granulocyte counts and in remission. These infections commonly affect the urinary tract and have lower mortality than febrile episodes.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- Infections are a major complication in acute leukemia patients.
- Distinguishing between febrile and afebrile infection episodes is crucial for patient management.
Purpose of the Study:
- To characterize afebrile infection episodes in adult acute leukemia patients.
- To compare afebrile infections with febrile infections in this population.
Main Methods:
- Retrospective analysis of infection episodes in adult acute leukemia patients.
- Comparison of clinical characteristics, infection sites, and outcomes between afebrile and febrile episodes.
Main Results:
- Afebrile infections constituted 14.3% of all infections.
- Afebrile episodes were associated with higher granulocyte counts (p < 0.001) and occurred more frequently in patients in complete remission (p < 0.0002).
- Urinary tract infections were more common in afebrile episodes (p = 0.0005), while lung involvement was less frequent (p < 0.01).
Conclusions:
- Afebrile infections represent a distinct clinical entity in acute leukemia, differing significantly from febrile infections.
- These findings suggest unique risk factors and clinical presentations for afebrile infections in acute leukemia.