Abstract
To elucidate the predisposing factors of terminal pulmonary infection in patients with lung cancer, we reviewed the case record of 251 autopsy cases that died of lung cancer in Kyushu University Hospital from 1976 to 1987. The incidence of mycobacteriosis was significantly more frequent in cases treated with antineoplastic therapy and corticosteroid (Group III) than in those with antineoplastic therapy but without corticosteroid (Group II), while the incidence of common bacterial and nonbacterial infections was not significantly different between the two groups. In patients with lung cancer treated with antineoplastic therapy, corticosteroid administration of relatively short duration (less than a month) induced fatal mycobacteriosis. In cases with lymphocytopenia, the incidence of fatal mycobacteriosis was significantly more frequent in Group III than in Group II, whereas the incidence of fatal nonbacterial infection was not. In cases with monocytopenia, both fatal mycobacteriosis and nonbacterial infection were significantly more frequent in Grroup III than in Group II. In Group III, the incidence of mycobacterial and nonbacterial infections was not different significantly between cases with and without lymphocytopenia or monocytopenia. Thus, in patients with lung cancer, administration of corticosteroid has greater influence on the development and exacerbation of mycobacteriosis than lymphocytopenia or monocytopenia. On the other hand, the influence of certicosteroid on the development and exacerbation of nonbacterial infection was significantly different from that of lymphocytopenia. The administration of corticosteroid and antineoplastic therapy do not increase the incidence of terminal common bacterial infection in patients with lung cancer.
