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2008, Number 84

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Rev Enfer Infec Pediatr 2008; 21.22 (84)

Children with cancer, neutropenia and fever. A three years study in the Miguel Hidalgo Specialty Hospital, Aguascalientes

Lucila Martínez Medina, Juana Dávila Ortega, Adriana Cajero Avelar, González PMR

Language: Spanish
References: 16
Page: 104-113
PDF size: 134.83 Kb.


ABSTRACT

With the arrival of the modern chemotherapeutic schemes, the secondary infectious disorders have arisen as serious threatening conditions.
A protocol was carried out in order to know in the patients that attend the Pediatric Oncology Unit at the Hospital Miguel Hidalgo, the frequency of cancer, neutropenia and fever, the isolated infectious agents, their antimicrobial sensitivity, and the low or high risk to acquire an infectious complication. With this information, we propose an outpatient therapeutic approach for low risk patients.
From 106 events of neutropenia and fever, an infectious agent was isolated only in 29.2% of the cases. Most were Gram negative bacilli sensitive to third generation cephalosporin and aminoglucosides. Two or more high risk factors for serious bacterial infections were identified in 68 of 106 (64%) events of neutropenia and fever. Low risk factors were identified in 38 of 106 (36%) events of neutropenia and fever. Most of the patients with low risk factors remained at the hospital from three to five days.
Thus, each pediatric oncologist must investigate in their patients, in order to plan the best early empirical approach, and to identify the low and high risk factors to acquire an infectious complication. With this information, the physician can select the best therapeutic option for each patient: at the hospital or in an outpatient basis.


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