• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.344-349
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• 2021

Background: Cancer patients have been disproportionally affected by the coronavirus disease 2019 (COVID-19) pandemic, with high rates of severe outcomes and mortality. Fever is the most common symptom in COVID-19 patients. During the COVID-19 pandemic, physicians may have difficulty in determining the cause of fever (COVID-19, another infection, or cancer fever) in cancer patients. Furthermore, there are no specific guidelines for managing cancer patients with fever during the COVID-19 pandemic. Thus, this study evaluated the clinical characteristics and outcomes of cancer patients with fever during the COVID-19 pandemic. Methods: This study retrospectively reviewed the medical records of 328 cancer patients with COVID-19 symptoms (fever) admitted to five hospitals in Daegu, Korea from January to October 2020. We obtained data on demographics, clinical manifestations, laboratory test results, chest computed tomography images, cancer history, cancer treatment, and outcomes of all enrolled patients from electronic medical records. Results: The most common COVID-19-like symptoms were fever (n=256, 78%). Among 256 patients with fever, only three (1.2%) were diagnosed with COVID-19. Most patients (253, 98.8%) with fever were not diagnosed with COVID-19. The most common solid malignancies were lung cancer (65, 19.8%) and hepatobiliary cancer (61, 18.6%). Twenty patients with fever experienced a delay in receiving cancer treatment. Eighteen patients discontinued active cancer treatment because of fever. Major events during the treatment delay period included death (2.7%), cancer progression (1.5%), and major organ dysfunction (2.7%). Conclusion: Considering that only 0.9% of patients tested for COVID-19 were positive, screening for COVID-19 in cancer patients with fever should be based on the physician's clinical decision, and patients might not be routinely tested.

• Journal of Korean Biological Nursing Science
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• v.25 no.2
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• pp.105-112
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• 2023

Purpose: This study aimed to understand the general characteristics and biomarkers of inflammation in adult patients who visited the emergency department with fever and to determine whether the severity of clinical symptoms varies according to cancer diagnosis. Methods: Data were collected retrospectively from 4,002 adult patients with fever who visited the emergency department at a tertiary hospital from January 2018 to December 2018 using medical records. Results: On average, cancer patients were older than non-cancer patients (p < .001), and differences were observed between cancer and non-cancer patients in the origin of fever and biomarkers associated with inflammation. A higher proportion of cancer patients than non-cancer patients had a Korean Triage and Acuity Scale level of 1 to 3 (p < .001), and more cancer patients than non-cancer patients met two or more criteria for systemic inflammatory response syndrome (p = .001). More life-saving interventions in the emergency department were required in cancer patients than in non-cancer patients (p < .001), and cancer patients spent more time in the emergency department than non-cancer patients (p < .001). Conclusion: This study showed that the general characteristics and biomarkers of inflammation differed among adult patients with fever depending on cancer diagnosis. Furthermore, among adult patients with fever, cancer patients had more severe clinical symptoms than non-cancer patients. The results of this study are hoped to be helpful as a basis of nursing knowledge for adult patients with fever in the emergency department and as evidence for the classification of severity in patients with fever according to cancer diagnosis.

• Journal of Sasang Constitutional Medicine
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• v.19 no.2
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• pp.179-186
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• 2007

1. Objectives In this case report, We report a case of advanced non-seminomatous germ tell tumor(NSGCT) of the testis to retroperitoneal lymph node. We successfully managed with sasang medical treatment. 2. Methods We treated a man with NSGCT of testis with retroperitoneal lymph node metastasis. We evaluated pain grade by VAS(visual analogue scale). and fever grade by body temperature(by axillary thermometer) 3. Results Pain and fever were improved with the Sasang constitutional medicine. 4. Conclusions Cancer pain and fever was markedly improved by Sasang Constitutional management. Further studies are needed to evaluate the cause of the improvement.

• Journal of Sasang Constitutional Medicine
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• v.24 no.4
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• pp.100-108
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• 2012

Objectives : The aim of this study was to report the improvement of fever, myalgia, performance status, and headache after treatment with Osuyubujaijung-tang and Geopoong-san in a Soeumin with Peripheral T-cell lymphoma. Methods : We retrospectively reviewed the medical records, medical laboratory and image scans of 80-year-old male patient diagnosed as peripheral T-cell lymphoma. He couldn't conduct any conventional chemotherapy due to poor performance status, ECOG 4. Results : The symptoms of myalgia, poor performance status, and neck pain improved, and fever was reduced with Osuyubujaijung-tang. Headache was subsided with Geopoong-san. Conclusions : A patient with peripheral T-cell lymphoma suffering from fever, myalgia, poor performance status, neck pain and headache showed the improvement of symptoms with treatment of Osuyubujaijung-tang and Geopoong-san. After 4 months treatment, the patient could conduct self care, physical activity and social affairs.

• CELLMED
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• v.2 no.2
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• pp.16.1-16.5
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• 2012

Fever in cancer patients is often due to the following causes: evil qi and toxity stagnancy, disorders of qi and blood, deficiencies of zang and fu organs, and the disorder of yin and yang. The treatments given to cancer patients with a fever are according to five: (a) Excessive inner heat and toxicants: remove heat and the toxicant, induce purgation. We use Cheng-Qi-Tang plus Qing-Wen-Bai-Du-Yin. (b) Tangle of damp and heat, and qi stagnancy: remove damp and heat, smooth the qi channel. We use Gan-Lu-Xiao-Du-Dan or San-Ren-Tang. (c) Obvious blood and heat stagnancy: remove heat and blood stasis. We use Xue-Fu- Zhu-Yu-Tang. (d) Deficiency of spleen qi, inner heat caused by a yin deficiency: nourish spleen qi and yin to remove the inner heat. We use Bu-Zhong-Yi-Qi-Tang or Xiao-Jian-Zhong-Tang. (e) Prominent yin deficiency and hectic fever: replenish yin and remove inner heat. We use Qing-Hao-Bie-Jia-Tang or Chai- Qian-Mei-Lian-San. The pathogenesis of fever in cancer patients is complicated. We can see both deficiency and excess in one differentiation. Therefore, we must make sure of it, then we can get the most effective treatment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4549-4553
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• 2014

Background: Infection is a serious cause of mortality in febrile neutropenia of pediatric cancer patients. Recently, monotherapy has replaced the combination therapy in empirical treatment of febrile neutropenia. Since there has been no reported trial comparing the efficacy of meropenem and piperacillin-tazobactam (PIP/TAZ) monotherapies, the present retrospective study was conducted to compare safety and efficacy in febrile neutropenic children with cancer. Materials and Methods: Charts of febrile, neutropenic children hospitalized at our center between March 2008 and April 2011 for hemato-oncological malignancies were reviewed. Patients received PIP/TAZ 360 mg/kg/day or meropenem 60 mg/kg/day intravenously in three divided doses. Duration of fever and neutropenia, absolute neutrophil count, modification, and success rate were compared between the two groups. Resolution of fever without antibiotic change was defined as success and resolution of fever with antibiotic change or death of a patient was defined as failure. Modification was defined as changing the empirical antimicrobial agent during a febrile episode. Results: Two hundred eighty four febrile neutropenic episodes were documented in 136 patients with a median age of 5 years. In 198 episodes meropenem and in 86 episodes PIP/TAZ were used. Duration of fever and neutropenia, neutrophil count, sex, and primary disease were not different between two groups. Success rates and modification rate between two groups showed no significant differences (p>0.05). Overall success rate in the meropenem and PIP/TAZ groups were 92.4% and 91.9% respectively. No serious adverse effects occurred in either of the groups. Conclusions: Meropenem and PIP/TAZ monotherapy are equally safe and effective in the initial treatment of febrile neutropenia in children with cancer.

• The Journal of the Korean Society for Microbiology
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• v.21 no.3
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• pp.387-391
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• 1986

Serum samples from 51 patients with clinically suspected typhoid fever were tested for immunoglobulin G (IgG), IgM and IgA antibodies against the whole bacteria antigen of Salmonella typhi by an enzyme-linked immunosorbent assay. The levels of IgG and IgA antibody to-whole bacteria antigen were higher in the culture-proven patients than in controls. The levels of IgM antibody to- whole bacteria antigen showed better discrimination between culture negative patients and controls than those of IgG or IgA antibody to-whole bacteria antigen. The enzyme-linked immunosorbent assay was much more sensitive than the Widal test. It would be a useful tool for the diagnosis of typhoid fever with a single serum sample.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.331-334
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• 2016

Purpose: Advanced cancer may accompany cold sweat as paraneoplastic symptom. Few studies have been performed on the efficacy of non-steroid anti-inflammatory drug (NSAID) in advanced cancer patients who sweated without fever. Methods: To select study participants, medical records were retrospectively reviewed for patients who satisfied the following criteria: 1) incurable, advanced solid cancer; 2) Cold sweating of 4 or higher on the numeric rating scale (NRS) 4; 3) No evidence of infection or hypoglycemia; 4) No newly started opioid or anti-hormonal agents within one month; 5) NSAID prescription for the management of cold sweating and 6) Documented NRS information before and after NSAID administration. Results: A total of 13 patients were selected after excluding four patients due to lack of NRS information or fever. The mean age was 59 years old (range: 50~71), and nine patients (69%) were male. Bile duct cancer was the most common primary tumor followed by pancreatic cancer, gastric cancer and prostate cancer. The mean NRS of cold sweating dropped from baseline 6.5 (min-max: 4~10) to 1.9 at the follow-up assessment (min-max: 0~5). The mean follow-up period was 9.1 days (range: 2~30 days) from NSAID treatment to assessment. Conclusion: NSAID was effective medication for management of sweating without fever in patients with advanced cancer.

• Journal of Gastric Cancer
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• v.10 no.4
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• pp.206-211
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• 2010

Purpose: Most surgeons administer prophylactic antibiotics for 3 to 5 days postoperatively. However, the Center for Disease Control (CDC) guideline recommends antibiotic therapy for 24 hours or less in clean/uncontaminated surgery. Thus, we prospectively studied the use of short term prophylactic antibiotic therapy after gastric cancer surgery. Materials and Methods: A total of 103 patients who underwent gastric cancer surgery between October 2007 and June 2008 were prospectively enrolled in a short term prophylactic antibiotics program. One gram of cefoxitin was administered 30 minutes before the incision, and one additional gram was administered intraoperatively for cases with an operation time over 3 hours. Postoperatively, one gram was administered 3 times, every 8 hours. Patients were checked routinely for fever. All cases received open surgery, and the surgical wounds were dressed and checked for Surgical Site Infection (SSI) daily. Results: Of the 103 patients, 15 were dropped based on exclusion criteria (severe organ dysfunction, combined resection of the colon, etc). The remaining 88 patients were included in the short-term program of prophylactic antibiotic use. Of these patients, SSIs were detected in 8 (9.1%) and fever after 2 postoperative days was detected in 11 (12.5%). The incidence of SSIs increased with patient age, and postoperative fever correlated with operation time. Conclusions: Short term prophylactic antibiotic usage is feasible in patients who undergo gastric cancer surgery, and where there are no grave comorbidities or combined resection.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.683-686
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• 2014

Objective: The purpose of the study was to evaluate clinical value of dual-phase $^{18}F$-FDG SPECT with serum procalcitonin (PCT) in identifying cancers in patients with fever of unknown origin (FUO). Methods: PCT test and dual-phase $^{18}F$-FDG SPECT were sequentially performed on 50 consecutive patients with FUO. Two radiologists evaluated all $^{18}F$-FDG SPECT data independently. A consensus was reached if any difference of opinions existed. Final diagnosis was based on a comprehensive analysis of results for the PCT test, dual-phase $^{18}F$-FDG SPECT and bacterial cultivation, regarded as a gold standard. Results: Among 50 patients, 34 demonstrated PCT ${\geq}0.5{\mu}g/L$. Coincidence imaging showed in 37 patients with inflammatory lesions, and 13 with malignancy. Finally, 36 bacterial, 1 fungal and 1 viral infections, as well as 12 cancerous fevers were confirmed by dual-phase $^{18}F$-FDG SPECT with PCT, combined with bacterial cultivation and clinical follow-up. Conclusion: Our study demonstrated that dual-phase $^{18}F$-FDG SPECT in association with PCT could be a valuable tool for diagnosis in tumor patients with FUO.