Severe febrile neutropenia in children with cancer: A descriptive study at the Hospital Universitario de Santander

摘要

align="justify">Objective: To describe an oncological population affected with severe febrile neutropenia, its demographic, nutritional, and microbiological features, their treatment and severity of the illness. Materials and methods: A descriptive-prospective clinical chart review from attended patients at the Hospital Universitario de Santander, from January/2007 to January/2008. Results: Twenty (21) patients contributed with 35 febrile neutropenia episodes; 65.7% were male; they aged average was 5.6-years; 38.37% lived in Bucaramanga Metropolitan Area; 91.4% had low economic status. The most frequent oncological diagnosis was acute lumphocytic leukemia. No one presented abdominal pain or neurological symptoms. The neutropenia was detected 8.5 days after the last chemotherapy cycle. 31.4% patients had no absolute neutrophils; 54.2% blood platelets 50,000/mm3, 45.7% had reactive C protein 90 mg|/dL. The bloodculture was positive only in 7 patients. It was found the infection focus in 88.6% of the episodes and the most frequently diagnosis were related with the gastrointestinal tract. The most used empiric antibiotic regimen was oxacilin+amikacin (71.4%), but were necessary change it in 40%. The lethality was of 4.8%. In average, 1.48 beds/day were occupied to treat this pathology. Conclusions: The patients with febrile neutropenia present multiple factors that could indicate us bacterial infection. Further investigations must continue to establish these factors and the bacterial flora of each institution. Many patients needed antibiotic change; that is the reason to define a new empiric treatment. Salud UIS 2010; 42: 103-111.