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Infections in Solid Tumor Patients

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Principles and Practice of Cancer Infectious Diseases

Part of the book series: Current Clinical Oncology ((CCO))

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Abstract

Over 90% of the 1.4 million new cases of cancer diagnosed in the United States in 2008 were due to solid tumors, with predominant sites being lung, breast, prostate, colorectal, bladder, and uterine cancers. While it is clear to practicing oncologists that solid tumor patients are generally at lower risk for infection-related complications overall, infections are certainly not rare in this population. Common foci include intravascular catheter-related bacteremia, pneumonias, wound and skin/soft tissue infections, and fever associated with chemotherapy-induced neutropenia. Nonetheless, there is little published data examining the incidence or characteristics of infections in solid tumor patients. This is not only because infection is relatively uncommon in solid tumor patients but also because sites, pathogens, and severity will vary, to a large extent, with tumor location, natural history, and the type and intensity of anticancer therapy. This variability precludes a neat summary of all the bacterial, viral, and fungal infections that occur in the solid tumor group as a whole. Instead, observational series and anecdotal reports have lead to the recognition of patterns of infection that may be considered “typical” for specific solid tumor types, or that are associated with certain antitumor treatment regimens. The goal of this chapter is to familiarize the physician with these infection profiles, so they may identify and manage them promptly and effectively.

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References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–49.

    Article  PubMed  Google Scholar 

  2. Kuderer NM, Dale DC, Crawford J, Cosler LE, Lyman GH. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer. 2006;106:2258–66.

    Article  PubMed  Google Scholar 

  3. Caggiano V, Weiss RV, Rickert TS, Linde-Zwirble WT. Incidence, cost, and mortality of neutropenia hospitalization associated with chemotherapy. Cancer. 2005;103:1916–24.

    Article  PubMed  Google Scholar 

  4. Klastersky J, Ameye L, Maertens J, Georgala A, Muanza F, Aoun M, et al. Bacteraemia in febrile neutropenic cancer patients. Int J Antimicrob Agents. 2007;30 Suppl 1:S51–9.

    Article  PubMed  CAS  Google Scholar 

  5. Spira A, Ettinger DS. Multidisciplinary management of lung cancer. N Engl J Med. 2004;350:379–92.

    Article  PubMed  CAS  Google Scholar 

  6. Cornillet A, Camus C, Nimubona S, Gandemer V, Tattevin P, Belleguic C, et al. Comparison of epidemiological, clinical, and biological features of invasive aspergillosis in neutropenic and nonneutropenic patients: a 6-year survey. Clin Infect Dis. 2006;43:577–84.

    Article  PubMed  CAS  Google Scholar 

  7. Pagano L, Caira M, Candoni A, Offidani M, Fianchi L, Martino B, et al. The epidemiology of fungal infections in patients with hematologic malignancies: the SEIFEM-2004 study. Haematologica. 2006;91:1068–75.

    PubMed  Google Scholar 

  8. Mackall CL. T-cell immunodeficiency following cytotoxic antineoplastic therapy: a review. Stem Cells. 2000;18:10–8.

    Article  PubMed  CAS  Google Scholar 

  9. Shiono S, Yoshida J, Nishimura M, Hagiwara M, Hishida T, Nitadori J, et al. Risk factors of postoperative respiratory infections in lung cancer surgery. J Thorac Oncol. 2007;2:34–8.

    Article  PubMed  Google Scholar 

  10. Lee JO, Kim DY, Lim JH, Seo MD, Yi HG, Kim YJ, et al. Risk factors for bacterial pneumonia after cytotoxic chemotherapy in advanced lung cancer patients. Lung Cancer. 2008;62:381–4.

    Article  PubMed  Google Scholar 

  11. Ohe Y, Yamamoto S, Suzuki K, Hojo F, Kakinuma R, Matsumoto T, et al. Risk factors of treatment-related death in chemotherapy and thoracic radiotherapy for lung cancer. Eur J Cancer. 2001;37:54–63.

    Article  PubMed  CAS  Google Scholar 

  12. Kyprianou A, Hall CS, Shah R, Fein AM. The challenge of nonresolving pneumonia. Knowing the norms of radiographic resolution is key. Postgrad Med. 2003;113:79,82, 85–8, 91–2.

    Google Scholar 

  13. Feinsilver SH, Fein AM, Niederman MS, Schultz DE, Faegenburg DH. Utility of fiberoptic bronchoscopy in nonresolving pneumonia. Chest. 1990;98:1322–6.

    Article  PubMed  CAS  Google Scholar 

  14. Perlman LV, Lerner E, D’Esopo N. Clinical classification and analysis of 97 cases of lung abscess. Am Rev Respir Dis. 1969;99:390–8.

    PubMed  CAS  Google Scholar 

  15. Yamada Y, Sekine Y, Suzuki H, Iwata T, Chiyo M, Nakajima T, et al. Trends of bacterial colonisation and the risk of postoperative pneumonia in lung cancer patients with chronic obstructive pulmonary disease. Eur J Cardiothorac Surg. 2010;37:752–7.

    Article  PubMed  Google Scholar 

  16. Los R, Rybojad P, Gozdziuk K, Malm A. Dynamics of nasopharyngeal colonization by gram-negative rods in patients with resectable lung cancer during short-term hospitalization. New Microbiol. 2008;31:507–12.

    PubMed  Google Scholar 

  17. Seo SK. Infectious complications of lung cancer. Oncology (Williston Park). 2005;19:185–94; discussion 195–6, 199–203, 207–8.

    Google Scholar 

  18. Limas C, Japaze H, Garcia-Bunuel R. “Scar” carcinoma of the lung. Chest. 1971;59:219–22.

    Article  PubMed  CAS  Google Scholar 

  19. Dacosta NA, Kinare SG. Association of lung carcinoma and tuberculosis. J Postgrad Med. 1991;37:185–9.

    PubMed  CAS  Google Scholar 

  20. Cha SI, Shin KM, Lee JW, Lee SY, Kim CH, Park JY, et al. The clinical course of respiratory tuberculosis in lung cancer patients. Int J Tuberc Lung Dis. 2009;13:1002–7.

    PubMed  Google Scholar 

  21. Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995;333:1456–61.

    Article  PubMed  CAS  Google Scholar 

  22. Simon MS, Cody RL. Cellulitis after axillary lymph node dissection for carcinoma of the breast. Am J Med. 1992;93:543–8.

    Article  PubMed  CAS  Google Scholar 

  23. Indelicato DJ, Grobmyer SR, Newlin H, Morris CG, Haigh LS, Copeland III EM, et al. Delayed breast cellulitis: an evolving complication of breast conservation. 2006;66:1339–46.

    Google Scholar 

  24. Wentling GK, Metzger PP, Dozois EJ, Chua HK, Krishna M. Unusual bacterial infections and colorectal carcinoma–Streptococcus bovis and Clostridium septicum: report of three cases. Dis Colon Rectum. 2006;49:1223–7.

    Article  PubMed  Google Scholar 

  25. Mirza NN, McCloud JM, Cheetham MJ. Clostridium septicum ­sepsis and colorectal cancer – a reminder. World J Surg Oncol. 2009;7:73.

    Article  PubMed  Google Scholar 

  26. Chew SS, Lubowski DZ. Clostridium septicum and malignancy. ANZ J Surg. 2001;71:647–9.

    Article  PubMed  CAS  Google Scholar 

  27. El-Masry S. Spontaneous gas gangrene associated with occult carcinoma of the colon: a case report and review of literature. Int Surg. 2005;90:245–7.

    PubMed  Google Scholar 

  28. Vaska VL, Faoagali JL. Streptococcus bovis bacteraemia: identification within organism complex and association with endocarditis and colonic malignancy. Pathology. 2009;41:183–6.

    Article  PubMed  Google Scholar 

  29. Phillips RK, Hittinger R, Fry JS, Fielding LP. Malignant large bowel obstruction. Br J Surg. 1985;72:296–302.

    Article  PubMed  CAS  Google Scholar 

  30. Lee YM, Law WL, Chu KW, Poon RT. Emergency surgery for obstructing colorectal cancers: a comparison between right-sided and left-sided lesions. J Am Coll Surg. 2001;192:719–25.

    Article  PubMed  CAS  Google Scholar 

  31. Sagar PM, MacFie J, Sedman P, May J, Mancey-Jones B, Johnstone D. Intestinal obstruction promotes gut translocation of bacteria. Dis Colon Rectum. 1995;38:640–4.

    Article  PubMed  CAS  Google Scholar 

  32. Tsai HL, Hsieh JS, Yu FJ, Wu DC, Chen FM, Huang CJ, et al. Perforated colonic cancer presenting as intra-abdominal abscess. Int J Colorectal Dis. 2007;22:15–9.

    Article  PubMed  Google Scholar 

  33. Heiss MM, Mempel W, Jauch KW, Delanoff C, Mayer G, Mempel M, et al. Beneficial effect of autologous blood transfusion on infectious complications after colorectal cancer surgery. Lancet. 1993;342:1328–33.

    Article  PubMed  CAS  Google Scholar 

  34. Eberhardt JM, Kiran RP, Lavery IC. The impact of anastomotic leak and intra-abdominal abscess on cancer-related outcomes after resection for colorectal cancer: a case control study. Dis Colon Rectum. 2009;52:380–6.

    Article  PubMed  Google Scholar 

  35. Nakamura T, Onozato W, Mitomi H, Sato T, Hatate K, Naioto M, et al. Analysis of the risk factors for wound infection after surgical treatment of colorectal cancer: a matched case control study. Hepatogastroenterology. 2009;56:1316–20.

    PubMed  Google Scholar 

  36. Nelson RL, Glenny AM, Song F. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2009;(1):CD001181.

    Google Scholar 

  37. Tartter PI, Mohandas K, Azar P, Endres J, Kaplan J, Spivack M. Randomized trial comparing packed red cell blood transfusion with and without leukocyte depletion for gastrointestinal surgery. Am J Surg. 1998;176:462–6.

    Article  PubMed  CAS  Google Scholar 

  38. Skanberg J, Lundholm K, Haglind E. Effects of blood transfusion with leucocyte depletion on length of hospital stay, respiratory assistance and survival after curative surgery for colorectal cancer. Acta Oncol. 2007;46:1123–30.

    Article  PubMed  Google Scholar 

  39. Welch S, Spithoff K, Rumble RB, Maroun J, the Gastrointestinal Cancer Disease Site Group. Bevacizumab combined with chemotherapy for patients with advanced colorectal cancer: a systematic review. Ann Oncol. 2010;21:1152–62.

    Article  PubMed  CAS  Google Scholar 

  40. Matsumoto T, Takahashi K, Tanaka M, Kumazawa J. Infectious complications of combination anticancer chemotherapy for urogenital cancers. Int Urol Nephrol. 1999;31:7–14.

    Article  PubMed  CAS  Google Scholar 

  41. Wolf Jr JS, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ, et al. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179:1379–90.

    Article  PubMed  Google Scholar 

  42. Bootsma AM, Laguna Pes MP, Geerlings SE, Goossens A. Antibiotic prophylaxis in urologic procedures: a systematic review. Eur Urol. 2008;54:1270–86.

    Article  PubMed  Google Scholar 

  43. Yamamoto S, Shima H. Controversies in antimicrobial prophylaxis for urologic surgery: more up-to-date evidence is needed. Nat Clin Pract Urol. 2008;5:588–9.

    Article  PubMed  CAS  Google Scholar 

  44. Falagas ME, Vergidis PI. Urinary tract infections in patients with urinary diversion. Am J Kidney Dis. 2005;46:1030–7.

    Article  PubMed  Google Scholar 

  45. Suriano F, Gallucci M, Flammia GP, Musco S, Alcini A, Imbalzano G, et al. Bacteriuria in patients with an orthotopic ileal neobladder: urinary tract infection or asymptomatic bacteriuria? BJU Int. 2008;101:1576–9.

    Article  PubMed  Google Scholar 

  46. Wah TM, Irving HC. Infectious complications after percutaneous radiofrequency ablation of renal cell carcinoma in patients with ileal conduit. J Vasc Interv Radiol. 2008;19:1382–5.

    Article  PubMed  Google Scholar 

  47. Carrafiello G, Lagana D, Ianniello A, Dionigi G, Novario R, Recaldini C, et al. Post-radiofrequency ablation syndrome after percutaneous radiofrequency of abdominal tumours: one centre experience and review of published works. Australas Radiol. 2007;51:550–4.

    Article  PubMed  CAS  Google Scholar 

  48. Nieder AM, Brausi M, Lamm D, O’Donnell M, Tomita K, Woo H, et al. Management of stage T1 tumors of the bladder: International Consensus Panel. Urology. 2005;66:108–25.

    Article  PubMed  Google Scholar 

  49. Lamm DL, van der Meijden PM, Morales A, Brosman SA, Catalona WJ, Herr HW, et al. Incidence and treatment of complications of bacillus Calmette-Guerin intravesical therapy in superficial bladder cancer. J Urol. 1992;147:596–600.

    PubMed  CAS  Google Scholar 

  50. Koya MP, Simon MA, Soloway MS. Complications of intravesical therapy for urothelial cancer of the bladder. J Urol. 2006;175:2004–10.

    Article  PubMed  Google Scholar 

  51. Seelig MH, Oldenburg WA, Klingler PJ, Blute ML, Pairolero PC. Mycotic vascular infections of large arteries with Mycobacterium bovis after intravesical bacillus Calmette-Guerin therapy: case report. J Vasc Surg. 1999;29:377–81.

    Article  PubMed  CAS  Google Scholar 

  52. Harding GE, Lawlor DK. Ruptured mycotic abdominal aortic aneurysm secondary to Mycobacterium bovis after intravesical treatment with bacillus Calmette-Guerin. J Vasc Surg. 2007;46:131–4.

    Article  PubMed  Google Scholar 

  53. Mavrogenis AF, Sakellariou VI, Tsiodras S, Papagelopoulos PJ. Late Mycobacterium bovis spondylitis after intravesical BCG therapy. Joint Bone Spine. 2009;76:296–300.

    Article  PubMed  Google Scholar 

  54. Soylu A, Ince AT, Polat H, Yasar N, Ciltas A, Ozkara S, et al. Peritoneal tuberculosis and granulomatous hepatitis secondary to treatment of bladder cancer with Bacillus Calmette-Guerin. Ann Clin Microbiol Antimicrob. 2009;8:12.

    Article  PubMed  Google Scholar 

  55. Alvarez-Mugica M, Gomez JM, Vazquez VB, Monzon AJ, Rodriguez JM, Robles LR. Pancreatic and psoas abscesses as a late complication of intravesical administration of bacillus Calmette-Guerin for bladder cancer: a case report and review of the literature. J Med Case Reports. 2009;3:7323.

    Article  Google Scholar 

  56. Sepkowitz KA. Opportunistic infections in patients with and patients without Acquired Immunodeficiency Syndrome. Clin Infect Dis. 2002;34:1098–107.

    Article  PubMed  Google Scholar 

  57. Ganiere V, Christen G, Bally F, Guillou L, Pica A, de Ribaupierre S, Stupp R. Listeria brain abscess, Pneumocystis pneumonia and Kaposi’s sarcoma after temozolomide. Nat Clin Pract Oncol. 2006;3:339–43; quiz following 343.

    Google Scholar 

  58. Slivka A, Wen PY, Shea WM, Loeffler JS. Pneumocystis carinii pneumonia during steroid taper in patients with primary brain tumors. Am J Med. 1993;94:216–9.

    Article  PubMed  CAS  Google Scholar 

  59. Su YB, Sohn S, Krown SE, Livingston PO, Wolchok JD, Quinn C, et al. Selective CD4+ lymphopenia in melanoma patients treated with temozolomide: a toxicity with therapeutic implications. J Clin Oncol. 2004;22:610–6.

    Article  PubMed  CAS  Google Scholar 

  60. Choi JD, Powers CJ, Vredenburgh JJ, Friedman AH, Sampson JH. Cryptococcal meningitis in patients with glioma: a report of two cases. J Neurooncol. 2008;89:51–3.

    Article  PubMed  Google Scholar 

  61. Aregawi D, Lopez D, Wick M, Scheld WM, Schiff D. Disseminated strongyloidiasis complicating glioblastoma therapy: a case report. J Neurooncol. 2009;94:439–43.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-5400, USA

    Alison G. Freifeld

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  1. Alison G. Freifeld
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Correspondence to Alison G. Freifeld .

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  1. MD Anderson Cancer Center, Infectious Diseases Department, The University of Texas, 800 5th Avenue, Apt. 12-G, New York, 10065, New York, USA

    Amar Safdar

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Freifeld, A.G. (2011). Infections in Solid Tumor Patients. In: Safdar, A. (eds) Principles and Practice of Cancer Infectious Diseases. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-644-3_4

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  • DOI: https://doi.org/10.1007/978-1-60761-644-3_4

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  • Publisher Name: Humana Press, Totowa, NJ

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