Thermometry in patients with cancer: Does oral mucositis has a confounding role?

Patients with cancer under chemotherapy who encounter oral mucositis are about 40% to 100%. Accurate diagnosis of fever among such patients is important as detecting fever among such patients particularly patients with fever and neutropenia can necessitate the start of antibiotics. It is more important when the oral method is the most common way for measuring the body temperature and oral mucositis may play a confounding role. According to importance of correct thermometry and high prevalence of oral mucositis in patients with cancer، the aim of this study was to compare the body temperature detected by oral، axillary and tympanic routes among the groups of patients with and without oral mucositis in self-referred or hospitalized patients of Hazrat Sayyed Al-Shohada (as) during 2010-2011. This is a cross-sectional study conducted among patients with cancer treated with chemotherapy with or without oral mucositis، hospitalized at Hazrat Sayyed Al-Shohada (as) during 2010-2011. We used simple non-random sampling method. Standard deviation was determined according to normal body temperature of 36. 8 ± 0. 4°C to use for calculating the sample population number. One hundred and sixty four patients were divided in two groups based on presence of oral mucositis (group A: with oral mucositis and group B: without oral mucositis) and then the temperature of the three areas of the mouth، axilla and tympanic in each group were measured، simultaneously. In the group of patients with oral mucositis in all three methods of temperature measurement by oral، axillary and tympanic compared to patients without oral mucositis، body temperature significantly was higher. Also in group A، the average temperature measured by mouth (37. 10°C) compared to the average temperature measured by axillary method (36. 85°C) was higher and was significantly different [δ=0. 25°C، p=0. 000]، while compared to the average tympanic temperature from right ear (37. 10°C); [δ=0° C، p=0. 48] and left ear (37. 11°C); [δ = 0. 01 ° C، p = 0. 46] did not differ significantly. In Group B، the difference between average oral temperature (36. 68°C) than Axillary (36. 32°C); [δ=0. 35°C، p=0. 000] were significant، but compared to the tympanic average temperature of the right ear (36. 74°C); [δ=0. 05°C، p=0. 16] and left ear (36. 70°C); [δ=0. 01°C، p=0. 385] were not significantly different. Based upon the study it seems in patients with cancer، oral mucositis as an important confounder، cannot cause error in the temperature measurement taken by mouth. Therefore start of proper treatment in this group of patients based on the temperature measured by mouth seems reasonable.