Infections in Cancer Patients

Infection is a common complication in cancer patients who receive cytotoxic chemotherapy and other targeted therapies. A clear understanding of the underlying host risk factors, the immunologic effects of specific cancer therapies, and the anatomic location of the tumor and its impact on surrounding structures helps predict the types of infection to which the host is most vulnerable. This review covers fever in the setting of neutropenia, infection risk with biological and targeted cancer therapy, and infections in patients with solid tumors. Figures show risk for fever and neutropenia, and empirical antibiotic algorithm for initial management of febrile neutropenia in patients at high risk for complications, radiographic findings associated with invasive fungal disease, a schematic of hepatitis B virus infection and reactivation after anti-CD20 therapy, and management of nonpurulent cellulitis in cancer patients. Tables list the Multinational Association of Supportive Care in Cancer (MASCC) risk index score, the Clinical Index of Stable Febrile Neutropenia (CISNE) scoring system, common bacterial pathogens that cause infection in neutropenic patients, assessment of specific signs and symptoms during febrile neutropenia, empirical antibiotic management of febrile neutropenia, criteria for addition of vancomycin to empirical antibiotic regimen for febrile neutropenia, and biological and targeted agents commonly used to treat hematologic malignancy and associated infections.   This review contains 5 highly rendered figures, 7 tables, and 107 references