Shaikh B S, Lombard R M, Appelbaum P C, Bentz M S
Oncology. 1982;39(2):78-82. doi: 10.1159/000225611.
A total of 59 infections were encountered in 29/46 patients with multiple myeloma (MM). Most infections arose in the urinary tract (31%), respiratory tract (29%), followed by blood (12%), oropharynx (12%), skin and soft tissue (7%). Gram-negative bacilli were identified in 51% of infections, most common being Enterobacteriaceae and Haemophilus influenzae. Gram-positive organisms were responsible for 7% of infections. 24% of patients with urinary tract infections had signs of cord compression Absolute lymphopenia was common, and was seen in 65% of patients with urinary infections, 75% of respiratory infections, and 86% of septicemic patients. In contrast, granulocytopenia was mainly observed in patients with septicemia (71%), followed by those with respiratory infections (31%). All patients were on cytotoxic chemotherapy, and most were hypoglobulinemic. About one third of septicemias, and one half of urinary and respiratory infections, respectively, were hospital-acquired. Results indicate that the current pattern of infections in MM seems to favor gram-negative organisms. The role of predisposing factors in the pathogenesis of infections in these patients is discussed.
46例多发性骨髓瘤（MM）患者中有29例共发生了59次感染。大多数感染发生在泌尿系统（31%）、呼吸道（29%），其次是血液（12%）、口咽（12%）、皮肤和软组织（7%）。51%的感染中鉴定出革兰氏阴性杆菌，最常见的是肠杆菌科和流感嗜血杆菌。革兰氏阳性菌导致7%的感染。24%的尿路感染患者有脊髓压迫体征。绝对淋巴细胞减少很常见，在尿路感染患者中占65%，呼吸道感染患者中占75%，败血症患者中占86%。相比之下，粒细胞减少主要见于败血症患者（71%），其次是呼吸道感染患者（31%）。所有患者均接受细胞毒性化疗，大多数患者存在低球蛋白血症。分别约三分之一的败血症以及一半的尿路感染和呼吸道感染是医院获得性的。结果表明，MM目前的感染模式似乎有利于革兰氏阴性菌。本文讨论了这些患者感染发病机制中易感因素的作用。
