Abstract
Seventeen consecutive episodes of blood culture-positive infection in 14 patients were evaluated out of 401 children with acute lymphocytic leukemia (ALL) between January 1919 and December 1988 in the Department of Pediatrics, Sapporo National Hospital.
The most frequent organism causing septicemia were Klebsiclla pneuntoniae and Staphylococcus epidermidis. Most cases of septicemia occurred during induction therapy or in relapse. All septicemia developed when the absolute neutrophil count was less than 500/mm3. The incidence of septicemia decreased with increasing levels of granulocytes. No children with granulocyte count greater than 1000/mm3 died in connection with septicemia. All the episodes occurring at the neutrophil count under 100/mm3 were fatal. Polymicrobic septicemia occurred 2 times and multiple episodes 5 times and high mortality rate were seen in these cases.
The prompt use of broad-spectrum antibiotics may be considered when granulocyto-penic patients with ALL become febrile.
