title: The epidemiology, clinical course and outcome of febrile cytopenia in children.
abstract: OBJECTIVE
  Transient infectious neutropenia of mild-to-moderate severity is common and resolves spontaneously within weeks. This was the first prospective study of the whole spectrum of febrile cytopenia in noncancer patients followed-up for 2 years. It aimed to assess its aetiology, duration and outcome.
  
  
  METHODS
  We evaluated 116 children with febrile cytopenia aged 4 ± 3.8 years, admitted to a paediatric ward over 2 years, using inflammatory markers, cultures and serological tests.
  
  
  RESULTS
  An infectious agent was identified in 74 (63.8%) cases: 44.8% viral, 11.2% bacterial and 7.8% parasitic. One cell line was affected in 26.7% of patients and ≥2 cell lines in 73.3%. Cytopenia was transient in 82.75% of cases and chronic in 17.24%. The transient cytopenia subgroups - exhibited differences in severity (mild in bacterial cases and moderate in viral and parasitic cases, p = 0.018) and the number of affected cell lines, (predominantly two in viral and bacterial cases and pancytopenia in parasitic cases, p = 0.001). Chronic patients had severe cytopenia (p = 0.004) with ≥2 cell lines affected, while transient patients had mild-to-moderate cytopenia, with 1-3 cell lines affected.
  
  
  CONCLUSIONS
  Childhood febrile cytopenia is usually transient, of mild-to-moderate severity, and resolves spontaneously, but patients with severe cytopenia affecting ≥2 cell lines need further evaluation and follow-up.
authors.affiliation: 2nd Department of Paediatrics, University of Athens, 'P&A Kyriakou' Children's Hospital, Athens, Greece.
authors.forename: Ourania
authors.initials: O
authors.lastname: Alexandropoulou
authors.forename: Lydia
authors.initials: L
authors.lastname: Kossiva
authors.forename: Maria
authors.initials: M
authors.lastname: Giannaki
authors.forename: Jp
authors.initials: J
authors.lastname: Panagiotou
authors.forename: Maria
authors.initials: M
authors.lastname: Tsolia
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Karavanaki
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D005334:Fever / Q000209:etiology*; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007970:Leukopenia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D008297:Male; D010198:Pancytopenia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome
keywords: Children; Cytopenia; Fever; Infections