Infection risk factors in febrile, neutropenic children and adolescents

Author(s): Konsler, G. K., Dunaway, R. P., Pusek, S. N.

Journal/Book: Pediatr Hematol Oncol. 1996; 13: 1900 Frost Road, Suite 101, Bristol, PA 19007-1598. Hemisphere Publ Corp. 217-229.

Abstract: We studied 276 fever episodes with an absolute neutrophil count (ANC) <500/mm(3) to determine patient characteristics predicting serious infection. Infections occurred in 38% of patients. Blood cultures were positive in 58% of documented infections. There was no difference in the rates of infection or positive blood culture when ANC was <200/mm(3) compared with a higher ANC. However, certain high risk infections were more common with an ANC <200/mm(3). Leukemia patients had more infections compared with other groups. Serious infections were more common during induction therapy or relapse. infection Incidence varied significantly with patient age and onset of fever in the Inpatients. Less than one fifth of febrile neutropenic episodes had no risk features for serious infection. We conclude that several clinical characteristics correlate with serious infection in febrile, neutropenic children and adolescents receiving modern supportive care. Despite improvements in supportive care measures, most febrile, neutropenic patients need close observation and empiric intravenous antibiotic therapy.

Note: Article GR Jones, Oregon Hlth Sci Univ, Doernbecher Mem Hosp Children, Div Pediat Hematol Oncol, Portland, OR 97201 USA

Keyword(s): children and adolescents; empiric antibiotics; fever and neutropenia; infection; CANCER-PATIENTS; FEVER; ANTIBIOTICS; MANAGEMENT; CATHETERS; EPISODES; CHEMOTHERAPY; SEPTICEMIA; MALIGNANCY; DISCHARGE

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