Pizzo P A
Pediatric Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892.
Eur J Cancer Clin Oncol. 1989;25 Suppl 2:S9-16.
During the last decade, the survival of patients with fever and neutropenia has continued to improve. This is largely a reflection of the increasing repertoire of antimicrobial agents available to treat the fevers and infections that arise in this ever-increasing population of patients. Although it would be optimal if therapeutic decisions could always be made based on the microbial isolates and their sensitivity patterns, this is generally not possible in the cancer patient. Fever remains the predominant manifestation of infection, but the underlying microbial etiology is infrequently delineated. In spite of improved diagnostic tests, clinical acumen along with vigilant and repetitive patient assessment remain the cornerstone for evaluation of the cancer patient who becomes febrile. Indeed, strict adherence to simple principles can have a significant impact on improving the chances for survival of cancer patients who develop fever or infection.
在过去十年中，发热伴中性粒细胞减少患者的生存率持续提高。这在很大程度上反映了可用于治疗发热及感染的抗菌药物种类不断增加，这类患者的数量也在不断增多。虽然如果治疗决策总能基于微生物分离株及其药敏模式来做出是最为理想的，但在癌症患者中通常无法做到这一点。发热仍然是感染的主要表现，但潜在的微生物病因很少能明确。尽管诊断测试有所改进，但临床敏锐度以及对患者进行警惕且反复的评估仍是评估发热癌症患者的基石。事实上，严格遵循简单原则可对提高发热或感染癌症患者的生存几率产生重大影响。
