Infectious complications associated with granulocytopenia during the treatment of poor risk or relapsed germ cell tumors.

Infectious complications associated with granulocytopenia during the treatment of poor risk or relapsed germ cell tumors were studied in order to assess the frequency, morbidity and characteristics of these complications. Thirty-three cases were investigated at the Institut Gustave-Roussy; 63 episodes of granulocytopenia were observed (mean duration 7.5 days). Twenty-four (38%) of the episodes of granulocytopenia were associated with fever. In 11/24 episodes (46%), fever was associated with a documented infection. Eighteen organisms were isolated. Ten were found to be Gram-positive, 7 Gram-negative, and one Candida. The major site of infection was the lungs. One death from septicaemia occurred. In conclusion, post-chemotherapy granulocytopenia during the treatment of germ cell tumors is associated with fever in less than 50% of cases. Bacterial infection was diagnosed in only 46% of febrile neutropenic episodes and rarely appears to be associated with a fatal outcome.