Septicaemia in the neutropenic patient.
A total of 29 cases of septicaemia proved by blood culture in 22 severely neutropenic patients with acute leukaemia or aplastic anaemia have been studied. The recovery rate was 75% in the Gram-positive septicaemias and 60% in the Gram-negative septicaemias in which treatment response could be evaluated. Neutropenia predisposed to septicaemia and its degree seemed to be important. The underlying state of the bone marrow was an important prognostic factor; the neutrophil count at the time of diagnosis and the infecting organism were less important. Gentamicin was the single most useful antibiotic, and the infection was controlled largely with gentamicin and one other antibiotic, most often carbenicillin. Possibly a similar result could have been obtained with gentamicin alone, but since the bacterial flora in a given environment is changeable empirical antibiotic regimens should remain flexible.