Bacterial infections in pediatric Hodgkin's disease.Relationship to radiotherapy, chemotherapy and splenectomy

Abstract

The occurrence of bacterial infections (B.I.) among 181 children with Hodgkin's disease (121 with splenectomy, 60 without splenectomy) was analyzed. Twenty-seven B.I. occurred among 22 children and included 15 episodes of bacteremia-meningitis in 14 children. B.I. occurred in all age groups, but bacteremia-meningitis occurred most commonly in splenectomized children 10 years of age or less. The frequency of B.I. in splenectomized children receiving radiotherapy was 1.4%, compared to 18.3% among those receiving chemotherapy (p < 0.05). the frequency of B.I. among non-splenectomized children receiving radiotherapy was 2.8%, compared to 23.1% among those receiving chemotherapy (p < 0.05). There was no difference in the probability of B.I. as a function of splenectomy for the corresponding groups, although all cases of streptococcus pneumoniae and hemophilus influenzae bacteremia-meningitis in splenectomized children. Overwhelming postsplenectomy bacteremia infection not related to active disease or treatment occurred in 3/121 (2.5%) children, accounting for only one fatality (0.8%).