Severe Bacterial Infection in Transfusion-Dependent Patients with Thalassemia Major

• Published in: Clinical infectious diseases Vol. 37; no. 7; pp. 984 - 988
• Main Authors: Wang, Shih-Chung, Lin, Kai-Hsin, Chern, Jimmy P. S., Lu, Meng-Yao, Jou, Shiann-Tarng, Lin, Dong-Tsamn, Lin, Kuo-Sin
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.10.2003; University of Chicago Press
• Subjects: Adolescent; Adult; Anemias. Hemoglobinopathies; Bacterial diseases; Bacterial infections; Bacterial Infections - etiology; Bacterial sepsis; Beta thalassemia; beta-Thalassemia - complications; beta-Thalassemia - therapy; Biological and medical sciences; Blood - microbiology; Brief Reports; Child; Child, Preschool; Diabetes mellitus; Diseases of red blood cells; Fever; Hematologic and hematopoietic diseases; Human bacterial diseases; Humans; Infections; Infectious diseases; Klebsiella pneumoniae; Liver abscess; Medical sciences; Predisposing factors; Pseudomonas aeruginosa; Sepsis; Suppuration; Thalassemia; Transfusion Reaction; Cornea; Transfusion; Diseases of the osteoarticular system; Hepatic disease; Hemopathy; Epidemiology; Kidney; Incidence; Splenectomy; Hemolytic anemia; Surgery; Osteitis; Bacteria; Intestinal disease; Ulcer; Enteritis; Diagnosis; Enterobacteriaceae; Gram negative bacteria; Buttock; Human; Hemoglobinopathy; Lung disease; Respiratory disease; Critically ill; Septicemia; Thalassemia; Genetic disease; Pulmonary abscess; Infection; Symptomatology; Bacteriosis; Digestive diseases; Liver abscess; Soft tissue; Severe; Klebsiella pneumoniae
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/378062

The incidence and clinical spectrum of severe bacterial infection were studied in 89 patients with thalassemia major that was diagnosed between January 1971 and March 2002. There were 20 patients with 24 episodes of severe bacterial infection, resulting in an incidence of 1.6 infections per 100 patient-years. The clinical spectrum included liver abscess (6 cases), septicemia (6 cases), soft-tissue infection (2 cases), osteomyelitis (2 cases), corneal ulcer (1 case), enteritis (1 case), and abscesses of the lung, kidney, intra-abdominal region, retropharynx, gums, and buttocks (1 case each). The leading causal microorganisms were gram-negative bacilli, especially Klebsiella pneumoniae (10 of 20 isolates). Other responsible pathogens were Pseudomonas aeruginosa (2/20), Vibrio vulnificus (2/20), Acinetobacter baumanii (1/20), Streptococcus intermidius (1/20), Yersinia enterocolitica (1/20), Staphylococcus aureus (1/20), Escherichia coli (1/20), and Salmonella species (1/20). Splenectomy and delays in the start of iron-chelating therapy were 2 independent risk factors.