Etiology of fever in Egyptian leukemic children

ABSTRACT

This study included 68 febrile leukemic children. There were 58 acute lymphoblastic leukemia [ALL], 7 acute mylocytic leukemia [AML] and 3 chronic mylocytic leukemia [CML]. Clinically diagnosed infections rated 60.3% versus laboratory diagnosed infections in 86.8%. Clinical features suggestive of infection represented 3.2% in respiratory tract, 23.5% in gastrointestinal tract and 7.4% in mucositis, cutaneous and CNS features. Laboratory investigations revealed bacterial infection in 89.7%, positive viral markers in 81%, fungal infection in 10.3% and protozoal infection in 20% [which were 2 out of 10 cases of group II]. Stool was the commonest site of organism isolation [86%] followed by throat [54.5%], then urine [8.8%] and lastly blood [3.4%]. E. coli recorded 75.9% of bacterial isolates followed by Streptococci in 37.9% of cases. Regarding viral markers, HBcAb prevailed in 85.4% followed by HCAb in 43.8%. It is concluded that in only 2.9% of cases, fever was due to other causes than infection and 39.7% of infected cases had no other signs or symptoms suggestive of infection apart from fever. The commonest organism isolated was E. coli followed by HBcAb