Infections in patients with multiple myeloma.

Infectious diseases are the leading causes of death in patients with multiple myeloma (MM). Major changes have occurred in the spectrum of infections paralleling the changes in the treatment of MM. Bacteria (particularly gram-negative organisms) are the most frequent etiologic agents, and invasive fungal infections caused by molds (Aspergillus sp. and Fusarium sp.) have been increasingly reported. New infections have emerged with an increase in the intensity of the treatment of MM. Management of infections in MM patients must include recognition of the likely pathogens. Specific strategies of diagnosis, prophylaxis, and empirical and specific therapy are based on host factors and probable pathogens.