Pattern of Infection in Hematologic Malignancies: An Indian Experience

Ninety-nine consecutive patients who received cytotoxic therapy for acute leukemia were retrospectively studied to determine the pattern of infection at the Tata Memorial Hospi-tal, Bombay, India. In all, 224 infective episodes occurred in these patients. Bacterial in-fection was the commonest type, accounting for 152 (67.9070) of 224 infective episodes, followed by fungal and viral infections (15.6 % and 14.3%, respectively). Gram-negative organisms (Pseudomonas and Klebsiella) were the commonest bacterial organisms iso-lated, constituting 38 (76%) of 50 positive cultures; infection with Staphylococcus was rare (10%). Infective hepatitis, malaria, and systemic tuberculosis were responsible for fever with neutropenia in 20,4, and 2 patients, respectively. Three hundred fifty-two pa-tients with lymphoproliferative malignancies were also retrospectively studied to deter-mine the pattern of infection. Only 53 infective episodes were recorded. In these patients, in contrast to those with acute leukemia, viral infection (33 [62.3%] of 53) and pulmo-nary tuberculosis (18 [34%] of 53) were frequently seen. It is interesting that 50 % of our patients with hairy cell leukemia also had tuberculosis. Bacterial infection was conspicu-ous by its absence. Knowledge of the prevailing pattern of infection permits the develop