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Chapter-22 Febrile Neutropenia

BOOK TITLE: Recent Advances in Pediatrics (Volume 20: Hot Topics)

Author
1. Abrol Pankaj
ISBN
9789350252475
DOI
10.5005/jp/books/11254_22
Edition
1/e
Publishing Year
2011
Pages
13
Author Affiliations
1. Pt BD Sharma Postgraduate, Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India, Pt. BD Sharma Postgraduate Institute of Medical Sciences, Rohtak, India, Pt BD Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India, Pt BD Sharma Institute of Medical Sciences, Rohtak, Haryana, India, Pt BD Sharma Postgraduate Institute of Medical Sciences, Rohtak, India
Chapter keywords

Abstract

This is a known fact that children suffering from malignancies are immune compromised. Over and above the existing malignancies, their immunity is adversely affected by such factors as cytotoxic chemotherapy, radiotherapy and intense surgical interventions. The net result is their enhanced vulnerability to various infections. Lower the neutrophil count, higher is the risk of infectious disease. Generally speaking, incidence of infections is inversely proportional to the neutrophil count and directly proportional to the duration of neutropenia. In other words, lower and more prolonged the neutrophilia, higher is the risk of infections. By definition, neutropenia is defined as a neutrophil count of 500/mm3 or less or a count of 100 cells/mm3 with a predicted fall to 500 cells/mm3 or less. Fever is defined as a single oral temperature of 38.3O C (100.4oF) or more, or a temperature of 38.0o C (100.4oF). In infected neutropenic patients, signs of inflammation/infection are minimal or absent. Following initial work up, all patients of febrile neutropenia are put on empirical broad spectrum antibiotics. Non-responders to antibiotic therapy may require antifungal agents. Use of hematopoietic growth factors shortens duration of neutropenia and hospital stay. Malignancy as such, drugs and transfusion of blood products also can cause fever in neutropenic patients.

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