Infections in febrile granulocytopenic patients: clinical features and pathogens

From 1990 to 1994, we prospectively evaluated patients with cancer or aplastic anemia who had granulocyte counts of less than 500/mm3 and fever, in order to study infections in febrile granulocytopenic patients in Taiwan. A total of 100 episodes in 95 patients were evaluated. Aerobic Gram-negative bacilli were responsible for 72.5% of the 80 organisms identified in the infections. Escherichia coli was the most common isolate, accounting for 46.5% of Gram-negative bacilli. Pseudomonas aeruginosa and Klebsiella spp caused 24.1% and 18.9% of these infections, respectively. Aerobic Gram-positive cocci were responsible for 12.5% of the 80 organisms identified in the infections. Fungal infections were responsible for 8.8% of isolates. Septicemia, predominantly due to Gram-negative bacilli, accounted for 39 episodes. Infection sites included the respiratory tract, urinary tract, skin and soft tissue, oral cavity, intestines, anus and ear canal. Identification of the pathogens and their clinical features is important in the immediate treatment of such infections.