Fever and neutropenia in children with cancer: diagnostic parameters at presentation
作者:
P Riikonen,
H Jalanko,
L Hovi,
UM Saarinen,
期刊:
Acta Pædiatrica
(WILEY Available online 1993)
卷期:
Volume 82,
issue 3
页码: 271-275
ISSN:0803-5253
年代: 1993
DOI:10.1111/j.1651-2227.1993.tb12658.x
出版商: Blackwell Publishing Ltd
关键词: Cancer;children;fever;neutropenia
数据来源: WILEY
摘要:
We evaluated 91 episodes of fever in 46 profoundly neutropenic children with cancer, in a search for any symptom, sign or laboratory test that would serve to identify patients with septicemia and differentiate them from those in no immediate need of prompt antimicrobial therapy. Seventeen episodes (19%) were bacteremias, 59 (64%) were suspected septic infections, 9 (10%) were focal bacterial infections and 6 (7%) proved not to be bacterial infections. We were unable to detect any parameter, either on admission or after two days of antimicrobial therapy (except for blood culture findings), that would be helpful in differentiating bacteremia from an episode not of bacterial origin. We focused on serum levels of C reactive protein and found them unreliable on an individual level. Prompt institution of antimicrobial therapy at the occurrence of fever results in low mortality, but does not allow assignment of cases to different categories.
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