ABSTRACT
Infections in patients with gynecological malignancies occur frequently and are the cause of death in 50 to 60% of the cases. The patient with cancer is a compromised host with an increased susceptibility to infection due to malignancy itself on the one hand and to therapeutic modalities, like extensive surgical procedures, radiation and cytotoxic chemotherapy on the other. Etiologically these infections are mostly due to a disruption of anatomical structures that normally prevent the invasion of the endogenous or exogenous microorganisms, or to obstructive processes or tumor necrosis. Septicemia can result from propagation ofsuch a localized infection beyond the site of the tumor. The causative pathogens infecting the compromised host are mostly members of the indigenous microbial flora of the genital tract, which is influenced by surgery, irradiation, and chemotherapy. Postoperatively in the vaginal vault the number .Qf most.notentiallv.pathogenic aerobic and anaer-
obic bacterial species is higher; polymicrobial mixed infections are frequent. Neither intracavitary radiation therapy with radium or iridium-l92 (after loading) nor external high-voltage therapy decreases the number of pathogenic bacterial species in the uterus or the vagina of patients with cervical or endometrial cancer. The symptoms of infection in cancer patients can be masked. Infections following radical hysterectomy, irradiation, and/or cytotoxic chemotherapy: such as pelvic abscesses, peritonitis, pneumonia, and septicemia, can be fatal. Urinary tract, wound, and vaginal vault infections occur frequently, but are rarely severe [I]. This chapter will review of the most common infections seen in gynecological oncology.
