CHAPTER 4. Infections in Solid Organ Cancer by Alison Freifeld

ABSTRACT

Over 90% of the 1.4 million new cases of cancer diagnosed in the US in 2008 were due to solid tumors, with predominant sites being lung, breast, prostate, colorectal, bladder and uterine cancers While it is clear to practicing oncologists that solid tumor patients are generally at lower risk for infection-related complications overall, infections are certainly not rare in this population.  Common foci include intravascular catheter-related bacteremia, pneumonias, wound and skin/soft tissue infections and fever associated with chemotherapy-induced neutropenia.  Nonetheless, there is little published data examining the incidence or characteristics of infections in solid tumor patients.  This is not only because infection is relatively uncommon in solid tumor patients, but also because sites, pathogens and severity will vary, to a large extent, with tumor location, natural history and the type and intensity of anticancer therapy. This variability precludes a neat summary of all the bacterial, viral and fungal infections that occur in the solid tumor group as a whole.  Instead, observational series and anecdotal reports have lead to the recognition of patterns of infection that may be considered “typical” for specific solid tumor types, or that are associated with certain anti-tumor treatment regimens.  The goal of this chapter is to familiarize the physician with these infection profiles so they may to identify and manage them promptly and effectively.