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neutropenia

A Case of Methotrexate-Induced Pancytopenia

A Case of Methotrexate-Induced Pancytopenia

Teaser: 

David Wan, School of Medicine, University of Toronto, Toronto, ON.
Shabbir M.H. Alibhai, MD, MSc, FRCPC, Staff Physician, Department of Medicine, University Health Network, Toronto, ON; Assistant Professor, Departments of Medicine & Health Policy, Management, and Evaluation, University of Toronto.

Case Presentation
Mr. L was a 75-year-old man who presented in April 2007 with a one-month history of multiple discrete ulcerative lesions on his extremities, his trunk, and in his mouth. He had progressive weakness and severely restricted oral intake over the past two weeks due to pain from his oral ulcers...

Fever in Older Cancer Patients: A Medical Emergency

Fever in Older Cancer Patients: A Medical Emergency

Teaser: 


Deepali Kumar MD, MSc, FRCP(C), Consultant, Infectious Diseases, Immunocompromised Host Service, University Health Network; Assistant Professor, University of Toronto, Toronto, ON.

The incidence of cancer continues to increase, and many persons receiving treatment for cancer are older adults. Fever in older adults with cancer can be an emergency. Any patient with fever and neutropenia should be given antibiotics as soon as possible. In addition to the immune senescence associated with aging, individuals with cancer have immunodeficiencies specific to their underlying malignancy, and these predispose them to specific infections. Older adults are also at higher risk of the complications of chemotherapy, including infections. Prompt evaluation and judicious management of the febrile cancer patient can reduce morbidity and mortality. The following review considers an approach to the etiologies and evaluation of fever in cancer including the infectious and noninfectious causes.
Key words: fever, cancer, older adults, antibiotics, neutropenia.