title: Febrile neutropenia: outline of management.
abstract: Febrile neutropenia is a common emergency encountered in children receiving chemotherapy for a malignancy. Left untreated, it can lead to serious morbidity and mortality. Febrile neutropenia is suspected in any patient on chemotherapy who presents with fever. Prompt evaluation and management by the primary contact pediatrician is essential for a successful outcome. A detailed history and physical examination is warranted to identify source of infection, although two thirds of them may not have localizing symptoms or signs. Risk stratification is valuable in categorizing the severity and guiding therapy. Initial stabilization, prompt initiation of appropriate antibiotics and adequate supportive care are the cornerstone of treatment. Knowledge of the locally prevailing bacteriological profile and antimicrobial susceptibility data is crucial for each hospital/unit to frame and periodically modify guidelines for the choice of antimicrobials. Delay in initiating antimicrobials significantly worsens the outcome. Education of the family as well as the members of the treating unit is important in this regard. Pro-active steps must be taken to reduce incidence of hospital acquired sepsis. Diagnosis and management in relevance to the emergency room is reviewed and institutional practice is shared.
authors.affiliation: Hematology-Oncology unit, Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Sapna
authors.initials: S
authors.lastname: Oberoi
authors.forename: Renu
authors.initials: R
authors.lastname: Suthar
authors.forename: Deepak
authors.initials: D
authors.lastname: Bansal
authors.forename: R K
authors.initials: RK
authors.lastname: Marwaha
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy; D002648:Child; D064147:Febrile Neutropenia / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D009369:Neoplasms / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents