Clinical Course of Febrile Neutropenia in Childhood Cancers at Sunprasitthiprasong Hospital

Abstract

          Febrile neutropenia (FN) are crucial complication in pediatric cancer patients who received chemotherapy. The lack of sign and symptom due to neutropenic conditions led to delayed empirical antibiotic and poor outcome. This retrospective design aimed to study the clinical characteristic, site of infection, clinical course, etiology organisms and outcome after developing clinical practice guideline of FN in pediatric patients with cancer. Medical
records of FN episode during January 2011 – December 2013 at pediatric cancer center at Sunpasitthiprasong Hospital were reviewed. There were 154 FN episodes in 88 patients; the most common cancer was acute lymphoblastic leukemia. The document of detected infection were 51.9%; oral and gastrointestinal tract infection 16.9%, skin 11%, pulmonary infection 11%, blood 8.4%, genitourinary tract 3.2%, otitis media 1.3% and central venous catheters infection 0.7%. Fever with unknown origin was judged 48.1 %. Gram negative bacteria were detected from blood and urine 7.8% and gram positive pathogen 5.2%. Fungal infections were identified in blood and pulmonary site 3.2%, and skin infections induced by virus pathogen were demonstrated 3.2%. The outcome of treatment was noted in improved outcome 91.6%, serious complication 5.2% and 3.2% mortality rate.