Chilcote R R, Baehner R L
J Pediatr. 1979 May;94(5):715-8. doi: 10.1016/s0022-3476(79)80136-5.
Fifty consecutive episodes of septicemia were studied in 41 children who had acute lymphoblastic leukemia. Seventy-six percent of these episodes occurred when the absolute granulocyte count was 200/mm3 or less and were caused by gram-negative enteric and gram-positive mucocutaneous bacteria. In eight patients, Streptococcus pyogenes was isolated at the time when ALL was diagnosed. Multiple anaerobic and aerobic isolates from a single blood culture were associated with abdominal distress, whereas Streptococcus pneumoniae and Hemophilus influenzae septicemia occurred in associated with respiratory illnesses. When patients with severe compromise of anatomic barriers or respiratory disease were excluded, 94% of all patients with septicemia had an AGC of less than 200/mm3. The data provide guidelines for treatment for febrile patients with ALL based upon the AGC, the phase of the disease, and on the presence of associated respiratory or abdominal findings.
对41例急性淋巴细胞白血病患儿的50次连续性败血症发作进行了研究。其中76%的发作发生在绝对粒细胞计数为200/mm³或更低时，由革兰氏阴性肠道菌和革兰氏阳性皮肤黏膜菌引起。8例患者在急性淋巴细胞白血病确诊时分离出化脓性链球菌。单次血培养中多种厌氧菌和好氧菌分离株与腹部不适相关，而肺炎链球菌和流感嗜血杆菌败血症则与呼吸道疾病相关。当排除解剖屏障严重受损或患有呼吸道疾病的患者后，所有败血症患者中有94%的绝对粒细胞计数低于200/mm³。这些数据为根据绝对粒细胞计数、疾病阶段以及相关呼吸道或腹部表现对急性淋巴细胞白血病发热患者的治疗提供了指导方针。
