Table 3. Characteristics of the patients diagnosed with a true infection.
Case | Gender | Age | Underlying Malignancy | Specimen | Diagnosis/Possible Source | Presentation/Clinical Symptoms | Prior Procedures | CVC or Other Device | Time to Diagnosis of Infectiona | Antibiotic Treatment | Other Treatment Intervention |
---|---|---|---|---|---|---|---|---|---|---|---|
1 | M | 55 | Urothelial cancer | Wound culture (deep abdominal wound) | Abdominal-pelvic subcutaneous abscess | Fever, chills, abdominal pain | Repair of large ventral hernia with primary closure | No | 28 days | Cephalexin for 14 days | I&D of abdominal abscesses, Wound Vacuum placement |
2 | F | 68 | Poorly differentiated chordoma of the foot | Superficial wound culture | Below-knee amputation site soft tissue infection and fluid collection | Pain and burning at prior amputation site | Right below knee amputation | No | 8 months and 26 days | Doxycycline and Ciprofloxacin for 14 days | none |
3 | M | 67 | Prostate cancer | Body fluid aspirate culture | Pelvic abscess | Fever, chills | Robotic radical prostatectomy | No | 2 months and 14 days | Linezolid for 14 days, followed by Sulfamethoxazole/Trimethoprim for 28 days | CT-guided drainage of pelvic fluid collection |
4 | M | 29 | Dermatofibrosarcoma | Body fluid aspirate culture | Left groin fluid collection at prior surgical site | Left groin pain | Inguinal mass resection | No | 23 days | Amoxicillin/Clavulanate for 14 days | US-guided fluid collection aspiration |
5 | M | 73 | Metastatic penile cancer | Body fluid aspirate culture | Left thigh fluid collection | Left thigh erythema and pain | Total urethrectomy, peritoneal urethrostomy, bilateral groin lymph node dissection | Port | 1 month and 29 days | Cephalexin for 28 days | US-guided drainage |
6 | M | 47 | Melanoma of the thigh | Body fluid aspirate culture | Left thigh abscess | Fever, pain at abscess site | Left thigh melanoma excision with groin LN dissection | No | 2 months and 11 days | Vancomycin and Ampicillin/Sulbactam for 3 days, transitioned to oral doxycycline on discharge for 14 more days | CT-guided drainage of abscess |
7 | F | 41 | Melanoma of the buttock | Body fluid culture (JP drain) | Groin surgical site infection (wound infection/cellulitis) | Fever, Purulent drainage from wound | Melanoma site resection and right groin lymphadenectomy | No | 31 days | Amoxicillin/Clavulanate and ciprofloxacin for 10 days | JP drainage |
8 | M | 64 | AML, s/p allogeneic HSCT | Blood culture (one culture positive) | Bacteremia, possibly CVC-associated | Fatigue, leukopenia | None | Yes (Hickman catheter) | N/A | Vancomycin IV for 10 days | CVC removal |
9 | F | 78 | Renal cell carcinoma | Blood Culture (one culture positive, polymicrobial) | Bacteremia, from prior surgical wound infection/dehiscence | Wound dehiscence | Spinal instrumentation and fusion | No | 1 month and 18 days | Vancomycin IV and oral Ciprofloxacin for 42 days | Spinal hardware removal |
10 | M | 49 | Germ cell testicular cancer | Urine culture | UTI | Dysuria, UA pyuria WBC >100/hpf, abdominal pain | None | Left ureteral stent | 3 months and 27 days | Ciprofloxacin for 14 days | none |
11 | M | 64 | Renal cell carcinoma | Urine culture | UTI | Urinary retention, UA pyuria WBC >100/hpf | Left open radical nephrectomy | Intermittent straight catheterizations | 26 days | Ciprofloxacin for 10 days | none |
12 | F | 59 | Metastatic breast cancer | Urine culture | UTI | UTI symptoms, not other specified, UA pyuria WBC >100/hpf | none | Implantable port | N/A | Nitrofurantoin for 14 days | none |
13 | F | 77 | Metastatic colorectal cancer | Urine culture | UTI | Urinary frequency, pain with urination, UA WBC >100/hpf | none | none | N/A | Trimethoprim-sulfamethoxazole for 14 days | none |
14 | F | 79 | Chronic lymphocytic leukemia | Urine culture | UTI | Frequent urination, UA WBC >100/hpf | none | none | N/A | Ciprofloxacin for 7 days | none |
aDuration between the date of surgical procedure performed and the date of infection occurred and culture taken.
CVC, central venous catheter; M, male; F, female; CT, computed tomography; US, ultrasound; JP, Jackson-Pratt drain; AML, acute myelogenous luekemia; s/p, status post; HSCT, hematopoietic stem cell transplant; N/A, not applicable; UTI, urinary tract infection; UA, urinalysis; WBC, white blood cell; hpf, high-power field.