ABSTRACT
BACKGROUNDS: Recently, there has been a rise of prevalence of gram positive infection among cancer patients with febrile neutropenia. The proportion of antibiotic-resistant gram positive infection has been growing lately, especially in Korea, where the rate of MRSA infection was over 70%. It brings to careful consideration of early glycopeptide treatment in febrile neutropenic patients if gram positive infection is suspected. Also until now, most studies concerning febrile neutropenic patients were mainly related to hematologic malignancy rather than solid tumor. MATERIALS AND METHODS: We evaluated clinical manifestations and risk factors for gram positive bacteremia in a cohort of 288 solid tumor patients who were more than 18 years old and had neutropenic fever after chemotherapy from January 2002 to December 2004 at the Department of Oncology, Yonsei Cancer Center, Seoul. RESULTS: We identified the cause of fever in 130 (45.1%) cases, of which 53 (18.4%) cases were blood stream infection. Gram positive organism was isolated in 27 cases which comprises 50.9% of blood stream infections, followed by gram negative organism (47.2%) and fungus (1.9%). A logistic regression analysis revealed that gram positive bacteremia was associated independently with central venous catheter (CVC) infection, oropharyngeal mucositis, skin and soft tissue infection in febrile neutropenic patients with solid tumor. CONCLUSIONS: Gram positive bacteremia was common among febrile neutropenic patients in solid tumor and was associated with CVC infection, oropharyngeal mucositis, skin and soft tissue infection. The early use of glycopeptide must be taken into account in such conditions.
Subject(s)
Adolescent , Humans , Bacteremia , Central Venous Catheters , Cohort Studies , Drug Therapy , Febrile Neutropenia , Fever , Fungi , Hematologic Neoplasms , Korea , Logistic Models , Methicillin-Resistant Staphylococcus aureus , Mucositis , Prevalence , Risk Factors , Rivers , Seoul , Skin , Soft Tissue InfectionsABSTRACT
BACKGROUNDS: Recently, there has been a rise of prevalence of gram positive infection among cancer patients with febrile neutropenia. The proportion of antibiotic-resistant gram positive infection has been growing lately, especially in Korea, where the rate of MRSA infection was over 70%. It brings to careful consideration of early glycopeptide treatment in febrile neutropenic patients if gram positive infection is suspected. Also until now, most studies concerning febrile neutropenic patients were mainly related to hematologic malignancy rather than solid tumor. MATERIALS AND METHODS: We evaluated clinical manifestations and risk factors for gram positive bacteremia in a cohort of 288 solid tumor patients who were more than 18 years old and had neutropenic fever after chemotherapy from January 2002 to December 2004 at the Department of Oncology, Yonsei Cancer Center, Seoul. RESULTS: We identified the cause of fever in 130 (45.1%) cases, of which 53 (18.4%) cases were blood stream infection. Gram positive organism was isolated in 27 cases which comprises 50.9% of blood stream infections, followed by gram negative organism (47.2%) and fungus (1.9%). A logistic regression analysis revealed that gram positive bacteremia was associated independently with central venous catheter (CVC) infection, oropharyngeal mucositis, skin and soft tissue infection in febrile neutropenic patients with solid tumor. CONCLUSIONS: Gram positive bacteremia was common among febrile neutropenic patients in solid tumor and was associated with CVC infection, oropharyngeal mucositis, skin and soft tissue infection. The early use of glycopeptide must be taken into account in such conditions.
Subject(s)
Adolescent , Humans , Bacteremia , Central Venous Catheters , Cohort Studies , Drug Therapy , Febrile Neutropenia , Fever , Fungi , Hematologic Neoplasms , Korea , Logistic Models , Methicillin-Resistant Staphylococcus aureus , Mucositis , Prevalence , Risk Factors , Rivers , Seoul , Skin , Soft Tissue InfectionsABSTRACT
Serous effusions have been most commonly associated with ascites, pericardial effusion, and heart failure. But, they have been considered to be an unusual form of complication in hypothyroidism and pleural effusion, which has been observed as an isolated finding in hypothyroidism is apparently rare and complete analysis of these types of hypothyroid-associated pleural effusions has yet not been described. We report a case of hypothyroidism associated with unilateral pleural effusion in a 77 year-old male patient who was improved through levothyroxine sodium with brief review of the literature.