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  • Title: Persistent fever after recovery from granulocytopenia in acute leukemia.
    Author: Talbot GH, Provencher M, Cassileth PA.
    Journal: Arch Intern Med; 1988 Jan; 148(1):129-35. PubMed ID: 3422147.
    Abstract:
    We reviewed the hospital admissions of 168 patients with acute leukemia to determine the incidence of persistent fever following recovery from chemotherapy-induced granulocytopenia. This phenomenon was observed during 26 (15.5%) hospital admissions. The microbiologically and/or clinically documented causes identified in 23 instances included viral infection (two patients), perirectal abscess (two patients), Hickman catheter-related bacteremia (two patients), intraabdominal infection (four patients), and nine fungal infections (five resolving pneumonia, one disseminated candidiasis, three focal hepatic and/or splenic mycosis). One patient had both cholecystitis and a pneumonia of uncertain origin and three patients had drug reactions. Although overall the source of fever was usually readily apparent, focal hepatic and/or splenic mycosis produced protracted fevers that were difficult to diagnose. Visceral fungal infection should be a leading diagnostic consideration in patients with leukemia who remain persistently febrile following recovery from chemotherapy-induced granulocytopenia.
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