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Infectious Complications of Mucositis in Postchemotherapy Neutropenic Cancer Patients

Three Case Reports and a Review of the Literature

Shah, Neepa MD*; Adashek, Jacob J. DO; Molinas, Natalia L. MD; Ramsakal, Asha DO, MBS; Greene, John N. MD§

Infectious Diseases in Clinical Practice: September 2019 - Volume 27 - Issue 5 - p 247–250
doi: 10.1097/IPC.0000000000000762
Review Articles

Mucositis is a common, painful, and potentially dangerous adverse effect of many chemotherapy regimens. The mucosal barrier can be compromised from oncologic therapies resulting in high levels of exposure to organisms. These are often normal flora that become opportunistic pathogens, especially in these patients who already have compromised cellular immunity from neutropenia and humoral immunity from cytotoxic agents. The combination of a hampered immune system along with breakdown of the mucosa can lead to severe infections and lead to complications that undermine patient outcomes. The most common types of infections that are seen in neutropenic patients are bacterial, followed by viral, and then fungal. This case series will outline 3 vignettes of patients who developed mucositis secondary to chemotherapy-induced neutropenia and will review the most common infections seen in this delicate patient population plus empiric treatment strategies. For this review, a literature search was made using Google Scholar Database. Key words searched included bacterial, fungal, viral, mucositis, and leukemia. Articles published between 1983 and 2018 were selected.

From the *Smolensk State Medical University, Mumbai, India

Western University of Health Sciences, College of Osteopathic Medicine of the Pacific, Pomona, CA; and Divisions of

Internal and Hospital Medicine

§Infectious Diseases and Tropical Medicine, Moffitt Cancer Center, Tampa, FL.

Correspondence to: Natalia L. Molinas, MD, Division of Internal and Hospital Medicine, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL 33612. E-mail:

The authors have no funding or conflicts of interest to disclose.

Online date: August 7, 2019

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