Formal adult infectious disease specialist consultations in the outpatient setting at a comprehensive cancer center (1998-2008): Diverse and impactful

G. Pongas, G. Hamilos, K. V. Rolston, Dimitrios P. Kontoyiannis

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Purpose: The literature on the impact of infectious disease (ID) consulations in the outpatient treatment of cancer is scarce. Methods: The medical records of consecutive adult patients with cancer formally evaluated by two board-certified ID specialists in an outpatient setting at our institution over a 10-year period (1998-2008) were reviewed retrospectively. The patients' demographics, referring departments, purposes for consultation, ID specialist recommendations, and overall impact of consultations on outcome were analyzed. Results: We identified 598 patients who underwent ID specialist consultations. Most of them had solid tumors (53%), predominantly breast cancer, whereas non-Hodgkin's lymphoma was the most common hematologic malignancy. Almost half of the patients (45%) had active malignancies, but few of them were severely neutropenic (8%) or had been receiving high doses of corticosteroids (17%). The most frequent requests for consultation were culture or serologic test (15%), and treatment of cellulitis and/or surgical wound infections (14%). Of 337 isolated pathogens, the most prevalent were methicillin-resistant Staphylococcus aureus (13%) and Pseudomonas aeruginosa (8%), as well as atypical mycobacteria (16%) and Aspergillus species (11%). ID specialists provided alternative diagnoses in 53% of the cases, including identification of a different infection (46%), a noninfectious etiology (29%), colonization (16%), and drug-related toxic effects (9%). Overall, we deemed the contribution of the ID specialist to be significant in 62% of the consultations. Conclusions: ID specialists contribute significantly to the outpatient care of individuals with cancer.

Original languageEnglish (US)
Pages (from-to)261-265
Number of pages5
JournalSupportive Care in Cancer
Volume20
Issue number2
DOIs
StatePublished - Feb 2012

Keywords

  • Cancer
  • Consultation
  • Infectious diseases
  • Outpatient

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