Occult infection as a cause of hip pain in a patient with metastatic breast cancer

Mackey, John R.; Birchall, I. W. J.; MacDonald, Neil

doi:10.1016/0885-3924(95)00065-7

Cited by 7 publications

(3 citation statements)

References 3 publications

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“…Fabiszewski et al 5 reported that treatment of fever with antibiotics did not alter the outcome of fever in institutionalized advanced Alzheimer patients, while some authors have reported improved pain control with the use of antimicrobials in a small number of patients with acute systemic or local infections. [6][7][8] Patient survival in this study was not affected by the presence of infection or the use of antimicrobials. In the study by Vitetta et al, 1 patients with documented infections had a longer median survival.…”

Section: Discussionmentioning

confidence: 78%

Antimicrobial Use in Patients with Advanced Cancer Receiving Hospice Care

White

Kuhlenschmidt

Vancura

et al. 2003

Journal of Pain and Symptom Management

104

103

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Patients with advanced cancer receiving hospice and palliative care are highly susceptible to infections. The decision whether to treat an active or suspected infection in end-of-life care may be difficult. In order to develop guidelines for the use of antimicrobials (antibiotics and antifungals) in palliative care, we discussed antimicrobial options with 255 patients with advanced cancer at the time they entered a community-based hospice and palliative care program. We subsequently documented the use and effectiveness of the antimicrobials employed during the palliative care period. Most patients (79.2%) chose either no antimicrobials or symptomatic use only. Choices were influenced by age, the desire for symptom control, life-prolongation issues, and the condition of the patient. After admission, 117 patients had a total of 129 infections, with the most common sites being urinary tract, respiratory tract, mouth/pharynx, and skin/subcutaneous tissues. The use of antimicrobials controlled symptoms in the majority of the urinary tract infections, but were less effective in controlling symptoms in the other sites of infection. Survival was not affected by the patients' choice of whether to use antimicrobials, the prevalence of infections, or the actual use of antimicrobials. Symptom control may be the major indication for antimicrobial use for patients receiving hospice and palliative care.

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Section: Discussionmentioning

confidence: 78%

Antimicrobial Use in Patients with Advanced Cancer Receiving Hospice Care

White

Kuhlenschmidt

Vancura

et al. 2003

Journal of Pain and Symptom Management

104

103

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“…MacKey and MacDonald described a patient in which a large psoas abscess resulted in severe abdominal pain. 42 Antibiotic therapy and surgical drainage resulted in good symptom control.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Review of the Frequency of Infections and Patterns of Antibiotic Utilization on a Palliative Care Unit

Pereira

Watanabe

Wolch

1998

Journal of Pain and Symptom Management

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Various disease-related and therapy-induced factors make cancer patients susceptible to infections. The epidemiology and management of infections in neutropenic cancer patients and patients with primary hematological malignancies has been widely reported, but very few studies have characterized infections and their management in palliative care patients. We conducted a retrospective review of 100 consecutive admissions to an acute palliative care unit with the objective of assessing overall and site-specific frequencies of infections, the pathogens involved and their antibiotics sensitivities, and the pattern of antibiotic utilization. The mean age was 64 +/- 11.5 years, the mean length of stay was 29.8 +/- 28.2 days, and 70% of patients died on the unit. Only one case of neutropenia was identified. Fifty-five of the 100 patients were diagnosed with a total of 74 separate infections. The most frequent sites of infections were the urinary tract (39.2%), the respiratory tract (36.5%), skin and subcutaneous tissues (12.2%), and blood (5.4%). Fifty-four culture-positive infections were identified. Overall, the most common organisms were Escherichia coli (22.9%), Staphylococcus aureus (20%), and Enterococcus (11.4%). Fifty-three of the 74 (71.6%) infections were treated with antibiotics. The decision-making process regarding treatment versus nontreatment of an infection can be complex in terminally ill patients and needs to be individualized. Symptom control is the primary objective in the majority of cases. The appropriate management of infections, with specific attention to measures that would improve patients' quality of life, should be a research priority in patients with advanced cancer.

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“…Green et al ont décris un contrôle efficace des symptômes liés aux infections chez 2 patients atteints de cancer qui ont été traités par antibiotiques [24]. Par ailleurs, Mac Key et Mac Donald ont décris un patient atteint d'un abcès du muscle psoas, et qui souffrait de violentes douleurs abdominales [25]. L'antibiothérapie et le drainage chirurgical ont eu comme effet un soulagement rapide du patient.…”

Section: Efficacité De L'antibiothérapieunclassified