Skin and Soft Tissue Infections in Patients with Solid Tumours

Abstract

Background. Skin and soft tissue infections (SSTIs) in cancer patients represent a diagnostic challenge, as etiologic diagnosis is often missing, and clinical assessment of severity is difficult. Few studies have described (SSTIs) in patients with solid tumours (STs). Patients and Methods. Records of patients with ST and SSTI, cared for at the University Hospital of Heraklion, from 2002 to 2006 were retrospectively studied. Results. A total of 81 episodes of SSTIs, occurring in 71 patients with ST, have been evaluated. Their median age was 65 years (34–82). The most common underlying malignancy was breast cancer in 17 patients (24%). Most episodes (89%) occurred in nonneutropenics. Cellulitis/erysipelas was the most common clinical presentation (56; 69%). Bacterial cultures were possible in 29 (36%) patients. All patients received antimicrobial therapy, while in 17 episodes (21%) an incision and drainage was required. Treatment failure occurred in 20 episodes (25%). Five patients (7%) died due to sepsis. None was neutropenic. Severe sepsis on admission (P = 0.002) and prior blood transfusion (P = 0.043) were independent predictors of treatment failure. Conclusion. SSTIs can be life threatening among patients with ST. Early diagnosis and appropriate treatment are of the utmost importance, since sepsis was proven a significant factor of unfavourable outcome.

Impact of Underlying Comorbidities on Outcomes of Patients Treated with Ceftaroline Fosamil for Complicated Skin and Soft Tissue Infections: Pooled Results from Three Phase III Randomized Clinical Trials

“…Overall clinical cure rates at TOC (CE population) were similar for ceftaroline fosamil monotherapy (89.7%) and for vancomycin plus aztreonam combination therapy (90.8%), and were similar regardless of comorbidity status, and consistent with results in the CE and MITT Presence of comorbidities may increase the likelihood of acquiring a cSSTI and have an impact on the progression and course of the condition as well as its response to treatment [5]. Comorbidities associated with impaired immune response include critical illness, elderly age, immunocompromised state, hepatic and renal disease, vascular insufficiency, and malignancy [5,9,13,14]. Such comorbidities represent risk factors for potentiation of cSSTI and poor wound healing.…”

“…Presence of comorbidities may increase the likelihood of acquiring a cSSTI and have an impact on the progression and course of the condition as well as its response to treatment [ 5 ]. Comorbidities associated with impaired immune response include critical illness, elderly age, immunocompromised state, hepatic and renal disease, vascular insufficiency, and malignancy [ 5 , 9 , 13 , 14 ]. Such comorbidities represent risk factors for potentiation of cSSTI and poor wound healing.…”

Upper Body Pain and Functional Disorders in Patients With Breast Cancer

“…Erysipelas is a bacterial infection that affects the dermis and dermal lymphatics often caused by group A β hemolytic streptococci [99,100]. Skin and soft tissue infections are seen more commonly in persons with breast cancer compared with persons with other solid tumors [101]. Erysipelas often appears between 10 months and 6 years after completion of locoregional therapy for breast cancer [100].…”

Evaluation of Risk Factors for Osteoporosis and Osteopenia in Male Patients Aged Over 60 Years of Age

“…Complicated skin and soft tissue infections are defined as infections involving deep soft tissue or requiring significant surgical intervention, or those in patients with a significant underlying condition such as DM, obesity, immunodeficiency, or venous or arterial insufficiency (1). A HCA-SSTI was defined as any SSTI in a patient who had been recently hospitalized (i.e., within the previous 30 days), had used antibiotics in the 30 days prior to admission, had been transferred from a nursing home, or required dialysis (4,5). A CA-SSTI was defined as an episode that developed in an outpatient setting or within 48 h after hospital admission in patients who did not fit the criteria for a HCA-SSTI (5).…”