Abstract
e19604 Background: The etiology of FN is well established in the US and the EU. Less is known about it in Colombia. This cohort attempts to fill this void. Methods: We collected prospectively the information on all FN cases with an established etiology that were admitted to the Clínica SOMA (A 160 bed-facility in Medellín, Colombia) from September 2010 to October 2011. FN was defined as the coexistence of an absolute neutrophile count (ANC) <500 and a temperature >38.3 degrees Celsius following cytotoxic chemotherapy for cancer. Results: Fifty four cases of FN with known etiology were found. Twenty four in males and 30 in females. Age range from 16 to 73 years-old (median: 42). Acute lymphoblastic leukemia was the underlying diagnosis in 16 (30%), acute myelogenous leukemia in 13 (24% ), and non-Hodgkin’s lymphoma in 11 (20%). HyperCVAD (with o without rituximab), IdaFlag, bortezomib and HiDAC account for 17 (31%), 12 (22%), 7 (13%), and 5 (9%) cases, respectively. FN occurred 2 to 32 days after chemotherapy (average of 10 days). In 20 (37%) cases ANC on admission was 0, and the average ANC on admission was 120. In 51 cases germs were isolated in the blood (94%). Gram-negative bacilli were isolated in 38 cases (76%), S. aureus in 4 (7%), Candidemia was established in 4 patients (2 with C. krusei and 2 with C. parapsilosis). Pulmonary aspergillosis was established in one case. Of note, two cases of hospital-acquired Legionella pneumophila were found (Table). All patients recovered to non-neutropenic ANC with resolution of the infections. No deaths due to FN occurred in this group of patients. Conclusions: In this cohort from Colombia we found a large predominance of gram-negative bacilli and the isolation of L. Pneumophilla, an unusual pathogen in FN. This pattern differs from the usual germ mix reported in other series. [Table: see text]
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