Current patterns of infection in multiple myeloma

In twenty-six of fifty-five patients with multiple myeloma admitted to The Mount Sinai Hospital between January 1, 1969, and June 30, 1970, a total of twenty-nine infections were found. Gram-negative organisms accounted for 72 per cent of the thirty-nine isolates obtained from these patients. Fourteen patients had urinary tract infections with negative blood cultures (patients without septicemia), and eleven others had a total of thirteen episodes of bacteremia (patients with septicemia). The group of patients without septicemia could not be distinguished from those with septicemia in respect to age, sex, drug therapy, blood urea nitrogen and serum calcium levels, or white blood cell and differential counts. Gram-negative isolates were obtained from six of eight patients with pneumonia. Almost all the patients had low serum levels of immunoglobulins M and A (IgM and IgA). Tuberculin skin tests gave negative reactions in the eight patients tested.