Infections in Patients With Multiple Myeloma

Carl W. Norden, MD
Arch Intern Med. 1980;140(9):1150-1151. doi:10.1001/archinte.1980.00330200026012.
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Streptococcus pneumoniae is the organism that classically comes to mind as being the causative agent of most infections in patients with multiple myeloma. However, reports by Meyers et al1 in 1972 and Twomey2 in 1973 emphasized that Gram-negative organisms were increasingly prevalent causes of infection in hospitalized patients with myeloma. My interest in examining the infectious complications of patients with myeloma, at our hospital, was stimulated by observing two patients with multiple episodes of infections with either S pneumoniae or Haemophilus influenzae, type b. Of 37 patients with myeloma, 20 had at least one infection during the 30-month period studied. Gram-negative enteric organisms accounted for the largest number of pathogens isolated; most occurred as the causative agent in nosocomial urinary tract infections. However, polysaccharide-encapsulated organisms (pneumococcus, meningococcus, and H influenzae), as well as Staphylococcus aureus, accounted for almost one half of the pathogens identified and, more importantly, were


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