Febrile Neutropenia in Children with Cancer: Approach to Diagnosis and Treatment

Abstract

Background: Febrile neutropenia is one of the major acute side effects of intensive treatment in pediatric cancer, necessitating prompt initiation of empirical broad-spectrum antibiotics. Patients may be classified as low or high risk according some risk factors (duration of neutropenia, depth of neutropenia, type of cancer, state of disease, bone marrow involvement, type of treatment, additional health problems). Initial evaluation of the febrile neutropenic child should include the history of the child, a detailed physical examination, blood culture (peripheral and catheter), urinalysis and culture, cultures of lesions. Result & Conclusion: The standard of care in febrile neutropenic children is that they should be hospitalized, especially if high risk, and should be treated urgently with intravenous wide spectrum empiric antibiotics, the spectrum covering P. Aeruginosa. Empiric treatment should be modified according to culture results and clinical situation. Other options for low risk patients are starting with intravenous treatment and continuing with per oral treatment or giving per oral antibiotic treatment from the beginning.