Infection in the Patient With Cancer

Infection is a common complication of certain cancer treatments, particularly cytotoxic chemotherapies and stem cell transplantation which render patients neutropenic for various periods. In the absence of adequate neutrophils, bacterial infections may cause rapid onset of sepsis, typically heralded by the occurrence of fever. Accordingly, immediate administration of empiric antibiotic therapy is a standard approach to neutropenic patients who develop fever. Additionally, the presence of indwelling venous catheters, recent surgery or prolonged use of steroids and other immunosuppressant drugs can potentiate infections. Risk of infection varies significantly with underlying disease and those with hematologic malignancies are most prone to serious infectious complications including bacteremias, pneumonias and invasive fungal infections while those undergoing cycles of cytotoxic therapy for solid tumors are less commonly affected. Oncologists and other providers of cancer care must be familiar with the types of infections that can occur in patients with different cancers and therapies, and have a working knowledge of how to manage fever during neutropenia as swift and proper intervention may be life-saving for many patients.