[Febrile neutropenia in children with cancer in a medical center of Santiago, Chile].
Febrile neutropenia in cancer patients is a common complication associated to chemotherapy and can be the first manifestation of a potentially lethal infection. In order to adapt our clinical practice to national clinical guidelines, we performed a retrospective review of clinical charts of all children admitted to the Pediatric Unit of Clinica Davila, from May 1, 2003 to December 31, 2004, with cancer, fever and neutropenia. A total of 57 febrile neutropenic episodes occurred in 25 children and in 44% (25/57) of them an infectious focus could be identified; respiratory infections were the most common (11/25). A microorganism could be identified in 16/57 (x%) of episodes, e.g. 12 recovered from blood cultures (42% coagulase negative Staphylococcus, 17% group viridans Streptococci, 17% Escherichia coli and Enterococcus sp, Candida albicans y Pseudomonas aeruginosa in 8% each one), 3 from a catheter (coagulase negative Staphylococci) and 1 from a bronchoalveolar lavage (Pneumocystis jiroveci). At admission, 63% of children received treatment with 2 antibiotics, mostly ceftazidime and amikacin (39%) and 21% received vancomycin. In 37% of patients therapy required adjustment due to a poor response. Fifty six episodes had a favorable resolution with one patient diying of septic shock. Frequency of microorganism detection, the distribution of species recovered and the favorable resolution are comparable to that reported from industrialized countries.
Arnello L
Marcela
M
Servicio de Pediatría, Clínica Dávila, Santiago, Chile. marcearnello@yahoo.com
Quintana B
Juan A
JA
Barraza C
Pamela
P
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D009503:Neutropenia / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents