Factores predisponentes de sepsis en micosis fungoide

Background: Sepsis is the main condition of mycosis fungoides (MF)-related mortality and usually occur associated with certain factors. Objective: To determine the incidence, etiology, predisposing factors and evolution related to sepsis in MF. Method: A retrospective study was made (1990-2000). 62 patients with MF (14 with sepsis and 48 without) were studied. We analized, in both groups, age, sex, clinical disease, febrile neutropenia, lymph node involvement, metastasis, atypical circulating cells and stage disease. Results: 14/62 (22.5%) patients had 21 septicemias: due to Staphylococcus aureus in 15 (7 meticillin-resistant) and to Streptococcus pneumoniae and gramnegative bacilli in the rest. Primary sites of infection were lymphomatous cutaneous ulcers (64.28%) and intravascular catheter-associated infection (28.57%). 17/21 (80.95%) septicemias correlated with a local infected site. The presence of lymphomatous cutaneous ulcers (p 5% (p<0.02) and stage IV disease (p<0.001) identified a subset of patients at high risk for sepsis. 57% of the septicemias were fatal in less than 30 days after cessation of antimicrobial therapy, 66% of them in IV stage disease. Conclusion: These information allows the physician to identify patients with MF at high risk for sepsis: those with erythroderma and/or lymph node, visceral or blood involvement and/or stage IV.