Title:Febrile Neutropenia in Children with Cancer: Approach to Diagnosis and Treatment
Volume: 14
Issue: 3
Author(s): Rejin Kebudi*Hande Kizilocak
Affiliation:
- Cerrahpasa Faculty of Medicine, Pediatric Hematology-Oncology, Istanbul University, Istanbul,Turkey
Keywords:
Childhood cancer, febrile neutropenia, pediatrics, diagnosis, treatment, patients.
Abstract: Background: Febrile neutropenia is one of the major acute side effects of intensive treatment
in pediatric cancer, necessitating prompt initiation of empirical broad-spectrum antibiotics.
Patients may be classified as low or high risk according some risk factors (duration of neutropenia,
depth of neutropenia, type of cancer, state of disease, bone marrow involvement, type of treatment,
additional health problems). Initial evaluation of the febrile neutropenic child should include the
history of the child, a detailed physical examination, blood culture (peripheral and catheter), urinalysis
and culture, cultures of lesions.
Result & Conclusion: The standard of care in febrile neutropenic children is that they should be
hospitalized, especially if high risk, and should be treated urgently with intravenous wide spectrum
empiric antibiotics, the spectrum covering P. Aeruginosa. Empiric treatment should be modified
according to culture results and clinical situation. Other options for low risk patients are starting with
intravenous treatment and continuing with per oral treatment or giving per oral antibiotic treatment
from the beginning.