Levine, Graw and Young1 recently reviewed all aspects of the problem of infection in leukemia, and Hughes2, in a series of 200 fatal cases of childhood leukemia, found that death was due to infection in 45% and that it was a contributing factor in another 35%. Thus, in the latter series, infection was a significant factor in the demise in 80% of children with leukemia. A common feature of infection is the rise in temperature, and it has been estimated that, in acute leukemias, between 60 and 80% of all febrile reactions are due to this cause. Infection is much more common in the presence of neutropenia and, when below 500 neutrophils per cu. mm. and particularly when this has persisted over one month, approximately 90% of these children will develop infection. In this situation, children do not develop the usual purulent reaction and may not even have the expected radiographic signs. Therefore, a fever, especially in a neutropenic individual, must be regarded as due to infection until proved otherwise. Blood cultures and all other relevant specimens should be collected and treatment commenced immediately.
KeywordsAcute Leukemia Childhood Leukemia Streptococcal Infection Aminoglycoside Antibiotic Prophylactic Regimen
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