Hennemann H H
Klin Wochenschr. 1985 Sep 2;63(17):821-6. doi: 10.1007/BF01732287.
Septicemia occurred in 81 (= 23.9%) of 339 patients with leukemias an malignant lymphomas during 1979-1984/VI. In leukemias the acute forms and in malignant lymphomas the high malignant forms were mostly affected. The frequency of gramnegative bacterias (46 = 56.8%) was higher than that of gram-positive bacterias (32 = 39.5%) and of fungus (3 = 3.7%). The frequency of septicemia in leukemias (alone) between 1966-1977 was 13.9%, between 1979-1984/VI 30%. In this comparison septicemias caused by gram-negative bacterias and fungus decreased, whereas gram-positive septicemias increased. The focus of septicemia remained unknown in 30 cases, Pneumonias and the urinary tract were the most common source, followed by the skin. All patients were under cytostatics and therefore leukopenic, most of them received corticosteroids simultaneously and were thus immunosuppressed. A combination of granulocytopenia less than 1,000 mm3 with hypogammaglobulinemia less than 10 rel.% were mostly found in acute leukemias and in chronic lymphatic leukemia. 41.5% of febrile episodes from all groups of these diseases were of non-microbic origin (local or septic) an thus possibly symptom of activity of the underlying disease.
1979年至1984年6月期间,339例白血病和恶性淋巴瘤患者中有81例(23.9%)发生败血症。白血病中的急性型和恶性淋巴瘤中的高恶性型受影响最为严重。革兰氏阴性菌(46例,占56.8%)的感染频率高于革兰氏阳性菌(32例,占39.5%)和真菌(3例,占3.7%)。1966年至1977年期间,白血病(单独发病)败血症的发生率为13.9%,1979年至1984年6月为30%。相比之下,由革兰氏阴性菌和真菌引起败血症的发生率下降,而革兰氏阳性菌败血症的发生率上升。30例患者的败血症感染源不明,肺炎和泌尿道是最常见的感染源,其次是皮肤。所有患者均接受细胞抑制剂治疗,因此白细胞减少,大多数患者同时接受皮质类固醇治疗,因此免疫受到抑制。急性白血病和慢性淋巴细胞白血病患者大多同时出现粒细胞减少症(低于1000/mm³)和低丙种球蛋白血症(低于10%)。这些疾病所有组中41.5%的发热发作源于非微生物因素(局部或败血症),因此可能是潜在疾病活动的症状。