Septicemia with bacteroides in patients with malignant disease

The incidence of bacteroides septicemia in a population of patients with malignant diseases did not exceed 2 percent of all septicemias. Eight patients died with bacteroides septicemia diagnosed before death. Eight patients died with septicemia, and the heart blood yielded bacteroides at autopsy. Two patients showed no classical signs of preterminal septicemia, but the heart blood grew bacteroides. Eight patients recovered from bacteroides septicemia. Bacteroides septicemia occurred with equal frequency in immunologically normal and compromised patients. The fatal outcome was associated with extensive injury to intestines or nasopharynx. Pneumonia, pleural effusion, and empyema developed in those patients who died. The clinical picture differed from that of bacteremia with enterobacteriaceae, because classical signs of endotoxin shock were not present. Because of the high fever and extensive leukocytosis occurring even in face of bone marrow depression without signs of frank endotoxin shock at its beginning, bacteroides septicemia clinically resembles staphylococcus sepsis. The antibiotics most commonly used in sepsis with enterobacteriaceae and in staphylococcus septicemia are of little value when bacteroides invades the blood stream. Erythromycin, the tetracyclines, and ampicillin appear useful; chlor-amphenicol is recommended only when both clinical and in vitro resistance to tetracyclines is encountered.