Infection Prevention for AML Patients

Sami Salvatora, a physician assistant at MD Anderson, shared the top ways AML patients can prevent infections. Watch our meeting with her from April 2023 below or read the summary of key points she talked about. 

Why AML Patients Are at High Risk for Infections

• Low white blood cell counts: Particularly, low neutrophils prevent the body from effectively detecting and combatting infections
• Chemotherapy: Chemotherapy further reduces the white blood cell count and weakens the body's defense
• Mucositis and GI system infections: The protective barrier of the GI system can be compromised, causing normal bacteria to enter the bloodstream and cause infections

Signs of Infection

• Fever: Often the first sign in AML patients, particularly those with neutropenia (very low white blood cell count)
  • Fever of 100.4°F (38°C) or higher in patients undergoing chemotherapy can be a sign of a medical emergency. These patients are advised to report to the emergency room immediately
• Skin infections like cellulitis can arise from cuts, animal bites, or insect bites. These infections show symptoms like redness, swelling, and discharge
• Respiratory infections might cause cough, congestion, or a runny nose
• Urinary tract infections (UTIs) can cause fever, burning during urination, urinary frequency, or confusion in older patients
• Foodborne illnesses can lead to inflammation in the colon or food poisoning

What is Bacteremia? 

• A blood infection, often signaled by fever
• Other symptoms: chills, very low blood pressure, rapid heart rate, cough, rash
• Diagnosed via blood cultures
• Immediate treatment involves the initiation of antibiotics, antifungal, and antiviral therapy

Infection Prevention Measures

• Hand hygiene: Regularly wash hands or use hand sanitizer
• Wearing masks: Especially in crowded places or medical facilities
• Avoiding ill contacts: Stay away from those who are sick or recently exposed to infections
• Dietary precautions: Avoid raw/undercooked meats and fish. For fruits and vegetables, it's advised to wash them thoroughly before consumption, and be cautious about where one eats
• Shaving risks: Avoid shaving with sharp razors to prevent micro-tears and nicks that can lead to infections. Use electric shavers instead, especially for those with a weakened immune system
• Medications: Anti-viral (like Valtrex or Acyclovir), antibiotics (like Levaquin or Cipro), and anti-fungal (like Fluconazole)
• Vaccinations: Patients are recommended to get non-live versions of flu and COVID-19 vaccines. Timing is essential, so discuss with providers. Vaccines are most effective when blood counts are ideal
• How to handle animal bites/scratches: Clean wounds immediately with an antiseptic and consult a healthcare provider. Animal bites or scratches, even from cats, can carry dangerous bacteria

When to Visit the Emergency Room

• When the AML patient has a fever, visible skin infections, cuts, injuries, and/or changes in mental status. Symptoms can appear suddenly

When to Call Your Doctor

• AML patients should establish the best way to reach their healthcare provider and should never hesitate to contact them, even for non-urgent questions

Guidance for Family/Friends

• Be informed about the patient's condition
• Encourage good hand hygiene and limited physical contact
• Avoid the patient when feeling ill
• Use masks and maintain cleanliness in shared spaces

AML patients have vulnerable immune systems and should take preventive measures to avoid infections. These patients are also encouraged to contact their healthcare provider with any questions they have whether big or small related to infections.

Want to Learn About More Adult AML Topics? 

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