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Pneumonien bei akuten Leukämien
Authors:H. H. Hennemann  W. Wundt  R. Schuh  B. Bauer
Affiliation:(1) III. Medizinische Klinik — Lehrstuhl für Innere Medizin II — und Institut für Hygiene und medizinische Mikrobiologie des Klinikums Mannheim der Universität Heidelberg, Germany;(2) III. Medizinische Klinik des Klinikums der Stadt Mannheim, Wiesbadener Str. 7–11, D-6800 Mannheim 31
Abstract:
Summary Acute leukaemia was complicated by pneumonia in 38 (34.8%) of 109 patients treated between 1979 and 1983; in 39.5% of the patients pneumonia occurred more than once. In 23 patients (60.5%) pneumonia occurred during cytostatic therapy, and 25 patients (65.8%) had less than 1000 mm2 granulocytes. Antibiotic therapy had no or only little effect in 70%. A total of 21 patients (55.3%) died of pneumonia. In 15 patients a direct relationship could be seen between pneumonia and the bacterial spectrum in the sputum. A prevalence of gram-negative bacteria was found (24 of 40 bacteria isolated, especially Enterobacteriaceae (19). Fungi were cultivated in 10 cases. Each of the typical pneumonia bacteria was only seen once respectively. It is most important that therapy begin immediately, even before the bacteria have been identified. Only then is there hope that the survival time of patients with acute leukaemia can be influenced.
Keywords:Pneumonia  Acute leukaemia  Immunosuppressive therapy  Gram-negative bacteria in sputum
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