Despite the current management of leukemia, the immune system of these patients is profoundly altered, and they continue to have many types of infections. They contribute a great deal to the morbidity and mortality of patients with leukemia, and it is important to know what types of infections are more common and why.
Leukemia features an accumulation of leukocytes that may appear to be mature, but are functionally incompetent. They are not able to trigger an immune response when they should and fail to defend the body against pathogens.
There are different types of infections in patients with leukemia. The most important are as follows:
Neutropenia is a reduction of blood levels of neutrophils, a type of white blood cells. They are essential to protect the body against bacterial pathogens and having leukemia with fever and low levels of neutrophils are referred to as febrile neutropenia.
Febrile neutropenia is associated with various infections in different parts of the body. For example, periodontal and oral infections by gram-negative bacteria, herpes simplex virus, and candida. Gastrointestinal infections by Clostridium difficile and anaerobes, associated with diarrhea. Lower respiratory tract infections, especially pneumonia due to pneumococci and gram-negative bacilli.
More severe infections in febrile neutropenia include bloodstream infections with staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus agents. As mentioned above, we can also have cellulitis and folliculitis caused by streptococci and staphylococci.