Caya J G, Farmer S G, Ritch P S, Wollenberg N J, Tieu T M, Oechler H W, Spivey M
Cancer. 1986 May 15;57(10):2045-8. doi: 10.1002/1097-0142(19860515)57:10<2045::aid-cncr2820571028>3.0.co;2-o.
The authors report an analysis of 47 leukemia patients (including 9 from our own medical center) whose courses were complicated by 48 episodes of clostridial septicemia. There were 36 adults and 11 children; acute myelogenous leukemia and acute lymphoblastic leukemia accounted for 61.7% and 14.9% of cases, respectively. All patients for whom remission status was known were in leukemic relapse. Fever was a presenting complaint in at least 36 patients whereas neutropenia, thrombocytopenia, and gastrointestinal lesions were noted in 100%, 90.9%, and 87.9%, respectively, of the patients for whom information on these parameters was available. Overall mortality from clostridial septicemia was 78%; none of the children and none of the patients with intravascular hemolysis survived. Overall, antibiotic therapy resulted in a 40% survival rate. However, among patients receiving beta lactam and/or chloramphenicol therapy, 57% survived their episode of clostridial septicemia. Prompt initiation of appropriate antimicrobial therapy offers the best chance of survival in leukemia patients with clostridial septicemia.
作者报告了对47例白血病患者（包括我们自己医疗中心的9例）的分析，这些患者的病程因48次梭菌败血症发作而变得复杂。其中有36名成人和11名儿童；急性髓性白血病和急性淋巴细胞白血病分别占病例的61.7%和14.9%。所有已知缓解状态的患者均处于白血病复发期。至少36例患者以发热为首发症状，而在有这些参数信息的患者中，分别有100%、90.9%和87.9%的患者出现中性粒细胞减少、血小板减少和胃肠道病变。梭菌败血症的总体死亡率为78%；儿童无一存活，血管内溶血患者也无一存活。总体而言，抗生素治疗的生存率为40%。然而，在接受β-内酰胺和/或氯霉素治疗的患者中，57%在梭菌败血症发作后存活。及时开始适当的抗菌治疗为患有梭菌败血症的白血病患者提供了最佳的生存机会。
