What Researchers Did
Doctors described four cases of a severe genital infection called Fournier's gangrene in patients with blood cancers who had very low white blood cell counts after chemotherapy, and reviewed how each case was treated.
What They Found
This case series followed four patients with acute leukemia or non-Hodgkin lymphoma who developed Fournier's gangrene during the aplastic phase after chemotherapy, when white blood cell counts fell below 500 per microliter. Cultures from two patients grew Pseudomonas aeruginosa, and cultures from a third patient grew both Pseudomonas aeruginosa and Proteus rettgeri. Early recognition along with aggressive antibiotic and surgical treatment, combined with recovery of white blood cell counts, resolved the gangrene in three of the four patients. In one patient whose illness was especially severe, hyperbaric oxygen therapy, which had not previously been reported in patients with blood cancers, was also very useful.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
This is a small case series of only four patients with no comparison group, so the specific contribution of hyperbaric oxygen therapy in the one patient who received it cannot be separated from the effects of antibiotics, surgery, and immune recovery.