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Henry Ford Hospital Medical Journal

Abstract

A comparison is made between incidence of fever in 132 patients with various types of disseminated cancer and 57 patients with diseases other than cancer during a 2- month observation period. Fifty-three febrile episodes were observed in cancer patients. Of these, 15 were of undetermined origin and 6 were noninfectious; none of the episodes occurred immediately following surgery. In the control group of 57 patients, there were 12 febrile episodes; of these, 7 were due to proven bacterial infection, 2 were due lo possible bacterial infection, and 3 were of undetermined etiology. All three febrile episodes in this latter group occurred postoperatively. The pathogenesis of fever is discussed, especially unexplained fever, in the absence of infection. Tissue necrosis, with the release of endogenous pyrogen, is suggested as a pathogenic mechanism in neoplastic fevers. It is of interest that unexplained fever was more prevalent in patients with demonstrable liver metastases. The metabolism of naturally occurring steroid hormones may be impaired by hepatic dysfunction. The role of steroid pyrogens remains undefined. Hepatic dysfunction may be a contributory factor.

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