RESUMO
The present study aimed at evaluating clinical and laboratory aspects during experimental envenomation by Crotalus durissus terrificus in dogs treated with antiophidic serum. Twenty-one dogs were divided into three groups of seven animals each. Group I received 1mg/kg venom (sc); Group II received 1mg/kg venom (sc), 50mg antiophidic serum (iv), and fluid therapy including 0.9% NaCl solution (iv); and Group III received 1mg/kg venom (sc), 50mg antiophidic serum (iv), and fluid therapy including 0.9% NaCl solution containing sodium bicarbonate diluted to the dose of 4mEq/kg. The clinical signs of ataxia, sedation, flaccid paralysis, mydriasis, eyeball paralysis, mandible ptosis, sialorrhea, vomiting and diarrhea observed in the dogs were very similar to those observed in humans. The decrease in hemoglobin, hematocrit, erythrocyte, platelet and fibrinogen levels, prolongation of clotting time, prothrombin time (PT) and activated partial thromboplastin time (APTT), as well as hypocellularity in the bone marrow characterized anemia, thrombocytopenia and blood incoagulability, as well as hypofibrinogenemia and decreased bone-marrow activity. Important bleeding was not observed. Increased numbers of leukocytes and neutrophils and decreased numbers of lymphocytes and eosinophils characterized an acute inflammatory response and stress caused by generalized pain. The employed antiophidic serum was effective and all animals survived.
RESUMO
The present study aimed at evaluating clinical and laboratory aspects during experimental envenomation by Crotalus durissus terrificus in dogs treated with antiophidic serum. Twenty-one dogs were divided into three groups of seven animals each. Group I received 1mg/kg venom (sc); Group II received 1mg/kg venom (sc), 50mg antiophidic serum (iv), and fluid therapy including 0.9 percent NaCl solution (iv); and Group III received 1mg/kg venom (sc), 50mg antiophidic serum (iv), and fluid therapy including 0.9 percent NaCl solution containing sodium bicarbonate diluted to the dose of 4mEq/kg. The clinical signs of ataxia, sedation, flaccid paralysis, mydriasis, eyeball paralysis, mandible ptosis, sialorrhea, vomiting and diarrhea observed in the dogs were very similar to those observed in humans. The decrease in hemoglobin, hematocrit, erythrocyte, platelet and fibrinogen levels, prolongation of clotting time, prothrombin time (PT) and activated partial thromboplastin time (APTT), as well as hypocellularity in the bone marrow characterized anemia, thrombocytopenia and blood incoagulability, as well as hypofibrinogenemia and decreased bone-marrow activity. Important bleeding was not observed. Increased numbers of leukocytes and neutrophils and decreased numbers of lymphocytes and eosinophils characterized an acute inflammatory response and stress caused by generalized pain. The employed antiophidic serum was effective and all animals survived.
Assuntos
Animais , Cães , Antivenenos/administração & dosagem , Antivenenos/uso terapêutico , Venenos de Crotalídeos/toxicidadeAssuntos
Masculino , Humanos , Idoso , Falso Aneurisma/patologia , Aneurisma Infectado/patologia , Aneurisma da Aorta Abdominal/patologia , Falso Aneurisma/cirurgia , Aneurisma Infectado/cirurgia , Aneurisma da Aorta Abdominal/cirurgia , Angiografia por Ressonância Magnética , Infecções Estafilocócicas/patologia , Infecções Estafilocócicas/cirurgiaAssuntos
Masculino , Humanos , Idoso , Falso Aneurisma/patologia , Aneurisma Infectado/patologia , Aneurisma da Aorta Abdominal/patologia , Falso Aneurisma/cirurgia , Aneurisma Infectado/cirurgia , Aneurisma da Aorta Abdominal/cirurgia , Angiografia por Ressonância Magnética , Infecções Estafilocócicas/patologia , Infecções Estafilocócicas/cirurgiaAssuntos
Masculino , Humanos , Idoso , Aneurisma Infectado/patologia , Aneurisma da Aorta Abdominal/patologia , Falso Aneurisma/patologia , Aneurisma Infectado/cirurgia , Aneurisma da Aorta Abdominal/cirurgia , Falso Aneurisma/cirurgia , Infecções Estafilocócicas/patologia , Infecções Estafilocócicas/cirurgia , Angiografia por Ressonância MagnéticaRESUMO
El objetivo de este estudo fue determinar la frecuencia y la incidencia de la tromboembolia venosa (TEV), objetivamente diagnosticada, en un hospital universitario argentino. Se utilizó un diseño retrospectivo, obsevacional y longitudinal. Se analizaran las historias clínicas de todos los pacientes mayores de 16 años que habítan egresado o fallecido en las unidades de internación clínica, obstétrica y quirúrgica del Hospital de Clínicas José de San Martin con el diagnóstico de TEV durante un período de 24 meses. La frecuencia y laincidencia de TEV fueron 0.92% y 0.40% ( intervalo de confianza de 95% (IC 95%) : 0.37 a 0.42%) respectivamente. La incidencia más alta de TEV se presentó en la novena década de la vida ( 0.80%; IC 95%: 0.78% a ).82% ). Solamente el 31% de los pacientes que desarrollaron TEV durante la interación habían recebido tromboprofilaxis con heparina. La mortalidad intra hospitalaria global de los pacientes con TEV fue 19%. (AU)
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Feminino , Tromboembolia/epidemiologia , Hospitais Universitários/estatística & dados numéricos , Hospitais Gerais/estatística & dados numéricos , Trombose Venosa/epidemiologia , Embolia Pulmonar/epidemiologia , Distribuição por Idade , Argentina/epidemiologia , Métodos EpidemiológicosRESUMO
El objetivo de este estudo fue determinar la frecuencia y la incidencia de la tromboembolia venosa (TEV), objetivamente diagnosticada, en un hospital universitario argentino. Se utilizó un diseño retrospectivo, obsevacional y longitudinal. Se analizaran las historias clínicas de todos los pacientes mayores de 16 años que habítan egresado o fallecido en las unidades de internación clínica, obstétrica y quirúrgica del Hospital de Clínicas José de San Martin con el diagnóstico de TEV durante un período de 24 meses. La frecuencia y laincidencia de TEV fueron 0.92% y 0.40% ( intervalo de confianza de 95% (IC 95%) : 0.37 a 0.42%) respectivamente. La incidencia más alta de TEV se presentó en la novena década de la vida ( 0.80%; IC 95%: 0.78% a ).82% ). Solamente el 31% de los pacientes que desarrollaron TEV durante la interación habían recebido tromboprofilaxis con heparina. La mortalidad intra hospitalaria global de los pacientes con TEV fue 19%.
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Humanos , Masculino , Feminino , Hospitais Gerais/estatística & dados numéricos , Hospitais Universitários/estatística & dados numéricos , Embolia Pulmonar/epidemiologia , Tromboembolia/epidemiologia , Trombose Venosa/epidemiologia , Distribuição por Idade , Argentina/epidemiologia , Métodos EpidemiológicosRESUMO
In order to define mortality rates and clinical findings with prognostic value in febrile infections among our adult patients with acute leukemia we prospectively studied--during a 34 months period--177 episodes of clinical suspected infection which occurred in 49 patients. By means of univariate analysis and a subsequent multiple logistic regression study, the association between 27 clinical and microbiological data and febrile episode survival rates were evaluated. Both the overall mortality rate and the specific one for febrile episodes were high (44.9% and 12.7% respectively). An age over 30 years old (p = 0.025), fever lasting more than five days (p = 0.025), lung involvement (p = 0.001) and fungal isolation in a culture specimen (p = 0.005) were all associated with a higher episode mortality. However, only an age older than 30 years (adjusted odds ratio, A.O.R. = 1.118; 95% confidence interval, C.I.95% = 1.015-1.232; p = 0.025) and pneumonia (A.O.R. = 1.454; C.I.95% = 1.288-1.642; p < 0.001) remained as independent predictors of a greater mortality in the multivariate analysis. Although fever of unknown origin was associated with a better prognosis (p = 0.024) two other variables--viral infections (A.O.R. = 0.642; C.I.95% = 0.421-0.979; P = 0.041) and the isolation of two or more etiologic agents (A.O.R. = 0.795; C.I.95% = 0.651-0.972; p = 0.027)--had a protective value with the multiple regression analysis.
Assuntos
Infecção Hospitalar/complicações , Febre/complicações , Leucemia/complicações , Adolescente , Adulto , Idoso , Infecção Hospitalar/microbiologia , Infecção Hospitalar/mortalidade , Feminino , Febre/microbiologia , Humanos , Leucemia/mortalidade , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/mortalidade , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidade , Prognóstico , Estudos ProspectivosRESUMO
In a study undertaken to evaluate fluoroquinolone prophylaxis in afebrile granulocytopenic patients, an unexpected association between chemotherapy schedule and a later development of bacteremia--during the subsequent febrile neutropenic episodes--was found. Twenty five febrile neutropenic episodes consecutive to chemotherapy for acute leukemia were studied. Patients received either etoposide and mitoxantrone or citarabine--in standard, intermediate or high doses--combined with daunomicin or mitoxantrone. Microbiologic data analysis showed an increased incidence of bacteremia with combined anthracycline and intermediate or high dose citarabine administration, when compared to etoposide and mitoxantrone use (p = 0.000387). Both groups developed similarly fast and severe neutropenias and equivalent grades of digestive mucositis. Chemotherapy schedule was the only factor associated with a consecutive bacteremia--or not--during the subsequent neutropenic episode. We conclude that effects other than bone marrow aplasia and digestive mucositis may be relevant in infectious susceptibility induced by cytostatic drugs.
Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Bacteriemia/prevenção & controle , Daunorrubicina/uso terapêutico , Leucemia/tratamento farmacológico , Neutropenia/induzido quimicamente , Doença Aguda , Adolescente , Adulto , Antimetabólitos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/efeitos adversos , Antineoplásicos Fitogênicos/administração & dosagem , Antineoplásicos Fitogênicos/efeitos adversos , Bacteriemia/etiologia , Citarabina/administração & dosagem , Citarabina/efeitos adversos , Quimioterapia Combinada , Etoposídeo/administração & dosagem , Etoposídeo/efeitos adversos , Feminino , Humanos , Masculino , Mitoxantrona/administração & dosagem , Mitoxantrona/efeitos adversos , Neutropenia/complicações , Neutropenia/tratamento farmacológico , Fatores de RiscoRESUMO
Characteristics of afebrile infection episodes among adult patients with acute leukemia are here described. Afebrile episodes represented 14.3% of all infections. They significantly differed from the febrile episodes because: 1) they prevailed among patients with granulocyte count greater than 500/mm3 (p < 0.001); 2) they often involved patients in complete remission (p < 0.0002); 3) they affected more frequently the kidney and urinary tract than febrile infections (p = 0.0005) and 4) they lacked lung involvement (p < 0.01). The rate of documented infections by cultures, cytology or serological tests was not different between both infection types. Observed mortality during afebrile episodes was threefold less than febrile infections; this difference, however, did not reach statistical significance. In conclusion, afebrile infection in acute leukemia is a distinct clinical entity, unlike febrile infection.
Assuntos
Leucemia/complicações , Infecções Urinárias/complicações , Adolescente , Adulto , Idoso , Feminino , Humanos , Leucemia Mieloide Aguda/complicações , Masculino , Pessoa de Meia-Idade , Neutropenia/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Estudos Prospectivos , Infecções Urinárias/diagnósticoRESUMO
Peritoneal mesothelioma is a rare neoplasia usually associated with exposure to asbestos. The incidence in the population not in contact with asbestos is of one per million per year. The disease is most common in males over the age of 40, with signs and symptoms of neoplasic disease together with abdominal pain and ascitis with or without a palpable abdominal mass. We report the case of a young male without a history of exposure to asbestos who presented with prolonged fever, leukocytosis and a septated peritoneal exudate. With a presumptive diagnosis of peritoneal tuberculosis, the patient received empirical antituberculosis treatment. Because the clinical picture persisted and microbiological studies remained negative, a second exploratory laparotomy was performed which demonstrated the presence of a malignant epithelial peritoneal mesothelioma.
Assuntos
Febre/etiologia , Leucocitose/etiologia , Mesotelioma/diagnóstico , Neoplasias Peritoneais/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Mesotelioma/complicações , Mesotelioma/patologia , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/patologiaRESUMO
Peritoneal mesothelioma is a rare neoplasia usually associated with exposure to asbestos. The incidence in the population not in contact with asbestos is of one per million per year. The disease is most common in males over the age of 40, with signs and symptoms of neoplasic disease together with abdominal pain and ascitis with or without a palpable abdominal mass. We report the case of a young male without a history of exposure to asbestos who presented with prolonged fever, leukocytosis and a septated peritoneal exudate. With a presumptive diagnosis of peritoneal tuberculosis, the patient received empirical antituberculosis treatment. Because the clinical picture persisted and microbiological studies remained negative, a second exploratory laparotomy was performed which demonstrated the presence of a malignant epithelial peritoneal mesothelioma.
RESUMO
Characteristics of afebrile infection episodes among adult patients with acute leukemia are here described. Afebrile episodes represented 14.3
of all infections. They significantly differed from the febrile episodes because: 1) they prevailed among patients with granulocyte count greater than 500/mm3 (p < 0.001); 2) they often involved patients in complete remission (p < 0.0002); 3) they affected more frequently the kidney and urinary tract than febrile infections (p = 0.0005) and 4) they lacked lung involvement (p < 0.01). The rate of documented infections by cultures, cytology or serological tests was not different between both infection types. Observed mortality during afebrile episodes was threefold less than febrile infections; this difference, however, did not reach statistical significance. In conclusion, afebrile infection in acute leukemia is a distinct clinical entity, unlike febrile infection.
RESUMO
We report a parkinsonian patient initially responding to L-dopa who developed a severe loss of drug efficacy due to Strongyloides stercoralis duodenitis. The patient was put on mebendazole and metronidazole, and the parasitosis abated, allowing L-dopa reduction by 33%. Our patient illustrates the advisability of searching for Strongyloides stercoralis when L-dopa malabsorption is suspected in Parkinson's disease.
Assuntos
Duodenite/metabolismo , Enteropatias Parasitárias/metabolismo , Levodopa/farmacocinética , Doença de Parkinson/complicações , Strongyloides stercoralis , Estrongiloidíase/metabolismo , Idoso , Animais , Duodenite/complicações , Duodenite/parasitologia , Humanos , Levodopa/uso terapêutico , Masculino , Mebendazol/uso terapêutico , Metronidazol/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/metabolismo , Estrongiloidíase/complicaçõesRESUMO
Argentina is facing an increase in cocaine use by adolescents and young adults from every socioeconomic background. It is calculated that up to 10% of all cocaine passing through this country is locally sold and consumed. Nevertheless, local information describing common cocaine-related neurological events is scarce. From August 1988 to March 1993, 13 patients were evaluated with neurological disease associated with cocaine abuse. Among these 13 patients (Table 1), the mean age was 29; 70% were men. Patients most commonly used the nasal route (snorting). Concomitant abuse of other intoxicants, especially alcohol, was frequent (85%). The major neurological complications included one or more seizures (n = 7), ischemic stroke (n = 2) (Fig. 1-2), hemorrhagic stroke (n = 2) associated with arteriovenous malformation (Fig. 3a-b), memory disturbances (n = 1) and paroxysmal dystonia (n = 1). Psychiatric complaints were present in all patients. Mortality was not observed. There was no correlation between the appearance of complications and the amount of cocaine used, or prior experience with this drug. Only one of the 7 patients with seizures had a previous history of seizures. All had generalized tonic-clonic seizures, and one had concomitant absence episodes. Cocaine modulates central neurotransmitters and has direct cerebrovascular effects. The neurological complications appear to be related to cocaine hyperadrenergic effects, striatal dopaminergic receptor hypersensitivity and perhaps vasculitis. Structural changes in the brain of long-term cocaine abusers could explain the persistence of neurologic symptoms after drug withdrawl.
Assuntos
Encefalopatias/etiologia , Cocaína , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Adulto , Alcoolismo/complicações , Coma/etiologia , Distonia/etiologia , Feminino , Humanos , Masculino , Parestesia/etiologia , Convulsões/etiologia , Tomografia Computadorizada por Raios XRESUMO
El consumo de cocaina ha adquirido proporciones epidemiológicas en los EEUU. Actualmente en nuestro país, sitio de paso de la droga, un 10 por ciento es retenida para su consumo, calculandose que un 80 por ciento de los drogadictos utilizan este alcaloide. Presentamos 13 paciente, 9 hombres y 4 mujeres con edades que oscilan entre 19 y 43 años que presentaron sintomatología por consumo de cocaína. Siete pacientes presentaron convulsiones y en uno de ellos se asociaron ausencias. Cuatro casos sufrieron accidentes cerebrovasculares, 2 de ellos isquémico y los otros hemorrágico, secundario a ruptura de malformaciones vasculares. Un paciente presentó fallas mnésicas severas y otro crisis distónicas paroxísticas. Todo menos uno consumían la cocaína por vía nasal y salvo 2 pacientes, el resto utilizaba otras drogas. El consumo concomitante de etanol era una práctica frecuente. La discontinuidad en el consumo del acaloide provó mejoría en las crisis epilépicas durante el período de seguimiento, salvo en el paciente con ausencias. El paciente con fallas mnésicas evidenció una marcada mejoría al cabo de 4 años de suspendida la cocaína. La paciente con crisis distónicas paroxísticas, al cabo de 2 años de haber suprimido la droga, persistía con el cuadro distónico. En 11 casos hubo una relación temporal entre el consumo de cocaína y la sintomatología neurológica, mientras que en los 2 restantes se debería al consumo crónico. Esto se debe a cambios farmacológicos y eventualmente estructurales en el sistema nervioso central. La frecuencia de estos casos, otrora excepcionales en nuestro medio, ha aumentado sensiblemente, obligando a considerar el consumo de este alcaloide en el enfoque diagnóstico de pacientes jóvenes con eventos neurológicos (AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Transtornos Relacionados ao Uso de Substâncias/complicações , Cocaína , Manifestações Neurológicas , Alcoolismo/complicações , Parestesia , Coma , Distonia , Tomografia Computadorizada por Raios XRESUMO
Argentina is facing an increase in cocaine use by adolescents and young adults from every socioeconomic background. It is calculated that up to 10
of all cocaine passing through this country is locally sold and consumed. Nevertheless, local information describing common cocaine-related neurological events is scarce. From August 1988 to March 1993, 13 patients were evaluated with neurological disease associated with cocaine abuse. Among these 13 patients (Table 1), the mean age was 29; 70
were men. Patients most commonly used the nasal route (snorting). Concomitant abuse of other intoxicants, especially alcohol, was frequent (85
). The major neurological complications included one or more seizures (n = 7), ischemic stroke (n = 2) (Fig. 1-2), hemorrhagic stroke (n = 2) associated with arteriovenous malformation (Fig. 3a-b), memory disturbances (n = 1) and paroxysmal dystonia (n = 1). Psychiatric complaints were present in all patients. Mortality was not observed. There was no correlation between the appearance of complications and the amount of cocaine used, or prior experience with this drug. Only one of the 7 patients with seizures had a previous history of seizures. All had generalized tonic-clonic seizures, and one had concomitant absence episodes. Cocaine modulates central neurotransmitters and has direct cerebrovascular effects. The neurological complications appear to be related to cocaine hyperadrenergic effects, striatal dopaminergic receptor hypersensitivity and perhaps vasculitis. Structural changes in the brain of long-term cocaine abusers could explain the persistence of neurologic symptoms after drug withdrawl.
RESUMO
El consumo de cocaina ha adquirido proporciones epidemiológicas en los EEUU. Actualmente en nuestro país, sitio de paso de la droga, un 10 por ciento es retenida para su consumo, calculandose que un 80 por ciento de los drogadictos utilizan este alcaloide. Presentamos 13 paciente, 9 hombres y 4 mujeres con edades que oscilan entre 19 y 43 años que presentaron sintomatología por consumo de cocaína. Siete pacientes presentaron convulsiones y en uno de ellos se asociaron ausencias. Cuatro casos sufrieron accidentes cerebrovasculares, 2 de ellos isquémico y los otros hemorrágico, secundario a ruptura de malformaciones vasculares. Un paciente presentó fallas mnésicas severas y otro crisis distónicas paroxísticas. Todo menos uno consumían la cocaína por vía nasal y salvo 2 pacientes, el resto utilizaba otras drogas. El consumo concomitante de etanol era una práctica frecuente. La discontinuidad en el consumo del acaloide provó mejoría en las crisis epilépicas durante el período de seguimiento, salvo en el paciente con ausencias. El paciente con fallas mnésicas evidenció una marcada mejoría al cabo de 4 años de suspendida la cocaína. La paciente con crisis distónicas paroxísticas, al cabo de 2 años de haber suprimido la droga, persistía con el cuadro distónico. En 11 casos hubo una relación temporal entre el consumo de cocaína y la sintomatología neurológica, mientras que en los 2 restantes se debería al consumo crónico. Esto se debe a cambios farmacológicos y eventualmente estructurales en el sistema nervioso central. La frecuencia de estos casos, otrora excepcionales en nuestro medio, ha aumentado sensiblemente, obligando a considerar el consumo de este alcaloide en el enfoque diagnóstico de pacientes jóvenes con eventos neurológicos
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Cocaína , Manifestações Neurológicas , Transtornos Relacionados ao Uso de Substâncias/complicações , Alcoolismo/complicações , Coma , Distonia , Parestesia , Convulsões , Tomografia Computadorizada por Raios XRESUMO
Para evaluar si el uso profiláctico de fluoroquinolona disminuye la incidencia y morbimortalidad de los episodios febriles durante la neutropenia, realizamos un estudio prospectivo, aleatorio y controlado en pacientes adultos con leucemia aguda (A.A.), con neutropenia secundaria a quimioterapia citotóxica y ambulatórios. Veinticinco episódios de neutropenia ocurridos en 14 pacientes fueron asignados aleatoriamente a recibir quinolonas (norfloxacina 800 mg/día o ciporfloxacina 1000 mg/dia), o a no recibir antibióticos profilácticos (grupo control). No hubo diferencias significativas entre ambos grupos en sexo, edad, tipo o estadio de la L.A., esquemas de quimioterapia empleados, duración y severidad de la neutropenia con fiebre (p = 0,0448), a una disminución del número de infecciones por bacilos gran negativos (p = 0,037), y a un aumento de las infecciones por Estreptococos (p = 0,0857). No hubo disminución significativa en la mortalidad, incidencia de infecciones severas, proporción de episodios de neutropenia sin fiebre, requerimiento de Anfotericina B, e incidencia de infecciones micóticas en el grupo con quinolonas respecto del control. Se concluye que la profilaxis con fluoroquinolonas no disminuyó la morbimortalidad infecciosa en estos pacientes (AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Neutropenia/tratamento farmacológico , Anti-Infecciosos/uso terapêutico , Infecções Bacterianas/prevenção & controle , Febre/prevenção & controle , Estudos ProspectivosRESUMO
Para evaluar si el uso profiláctico de fluoroquinolona disminuye la incidencia y morbimortalidad de los episodios febriles durante la neutropenia, realizamos un estudio prospectivo, aleatorio y controlado en pacientes adultos con leucemia aguda (A.A.), con neutropenia secundaria a quimioterapia citotóxica y ambulatórios. Veinticinco episódios de neutropenia ocurridos en 14 pacientes fueron asignados aleatoriamente a recibir quinolonas (norfloxacina 800 mg/día o ciporfloxacina 1000 mg/dia), o a no recibir antibióticos profilácticos (grupo control). No hubo diferencias significativas entre ambos grupos en sexo, edad, tipo o estadio de la L.A., esquemas de quimioterapia empleados, duración y severidad de la neutropenia con fiebre (p = 0,0448), a una disminución del número de infecciones por bacilos gran negativos (p = 0,037), y a un aumento de las infecciones por Estreptococos (p = 0,0857). No hubo disminución significativa en la mortalidad, incidencia de infecciones severas, proporción de episodios de neutropenia sin fiebre, requerimiento de Anfotericina B, e incidencia de infecciones micóticas en el grupo con quinolonas respecto del control. Se concluye que la profilaxis con fluoroquinolonas no disminuyó la morbimortalidad infecciosa en estos pacientes