Mucocutaneous infections in hematological malignancies

INTRODUCTION: Mucocutaneous infections of diverse etiology are frequent complications in patients with hematological malignancies. OBJECTIVE: To study the incidence, predisposing factors, microbiology, and primary clinical manifestations of these complications in oncohematological patients. MATERIAL AND METHODS: The study included 862 patients (394 females and 468 males) with hematological malignancies, treated in the Clinic of Hematology of the Higher Medical Institute, Plovdiv from 1990 to 1998. The patients were divided into three groups according to the primary disorder: lymphoproliferative disorders (541 patients), myeloproliferative disorders (296 patients), and bone marrow insufficiency (25 patients). RESULTS AND DISCUSSION: The mucocutaneous infections studied included most often abscesses and pyodermias. The predominant isolate was Staphylococcus aureus. Viral infections were caused mainly by herpes simplex virus type I and, less frequently, varicella zoster virus with intercostal localization. Candida species was isolated predominantly in oropharyngeal and esophageal mycoses. CONCLUSION: Prolonged cytostatic-induced neutropenia and suppressed cellular immune response are the principal factors for the infectious complications in hematological malignancies. The early clinical diagnosis and prompt etiological treatment of the mucocutaneous infections are crucial for the prophylaxis of the systemic infectious complications.