title: How to treat severe infections in critically ill neutropenic patients?
abstract: Severe infections in neutropenic patient often progress rapidly leading to life-threatening organ dysfunction requiring admission to the Intensive Care Unit. Management strategies include early adequate appropriate empirical antimicrobial, early admission to ICU to avoid any delay in the diagnostic and therapeutic management of organ dysfunction. This review discusses the main clinical situations encountered in critically ill neutropenic patients. Specific diagnostic and therapeutic approaches have been proposed for acute respiratory failure, shock, neutropenic enterocolitis, catheter-related infections, cellulitis and primary bacteriemia. Non anti-infectious agents and recent advances will also be discussed. At present, most of large-scale studies and recommendations in neutropenic patients stem from hematological patients and will need further validation in ICU patients.
authors.forename: Lara
authors.initials: L
authors.lastname: Zafrani
authors.affiliation: AP-HP, Hôpital Saint-Louis, Medical ICU, Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique (Grrr-OH), Paris, France. elie.azoulay@sls.aphp.fr.
authors.forename: Elie
authors.initials: E
authors.lastname: Azoulay
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy / Q000276:immunology*; D003422:Critical Care; D016638:Critical Illness; D006801:Humans; D016867:Immunocompromised Host; D007362:Intensive Care Units; D009181:Mycoses / Q000188:drug therapy / Q000276:immunology*; D009503:Neutropenia / Q000276:immunology* / Q000382:microbiology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents