• Pediatric emergency care · Mar 2021

    Infections in Children With Cancer: The Role of the Presence or Absence of Neutropenia.

    • Kyriaki Karavanaki, Lydia Kossiva, Rigina Sklavou, Kostas Kakleas, Charalambos Tsentidis, Dimitris Gourgiotis, Antonis Marmarinos, Triantafyllia Sdogou, Maria Tsolia, and Sophia Polychronopoulou.
    • From the Second Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, "P & A Kyriakou" Children's Hospital.
    • Pediatr Emerg Care. 2021 Mar 1; 37 (3): 155160155-160.

    BackgroundInfections in patients with cancer are a major cause of morbidity and mortality. In most cases, the presence of neutropenia renders them prone to infections to either common or opportunistic pathogens. A wide spectrum of bacterial, viral, or fungal agents is encountered in these patients.AimThe aim of this study was to evaluate infection types and pathogens in pediatric patients with cancer with and without neutropenia.MethodsA total of 37 pediatric patients with cancer (median age ± 25% quartile, 6.0 ± 2.0% years) with 70 febrile episodes were evaluated at fever's onset and 48 hours later with complete blood count, C-reactive protein, cultures of biological fluids, polymerase chain reaction, and antibody titers.ResultsOf 70 infections, 30 (42.85%) were bacterial, 13 (18.57%) were viral, 3 (4.28%) were fungal, 16 (22.85%) were fever of unknown origin, 18 (25.71%) were opportunistic, and 12 (17.14%) were mixed infections. Neutropenia was detected in 42 (60.0%) of 70 febrile episodes, mainly in patients with hematological malignancies [odds ratio, 2.81 (0.96-8.22); P = 0.059]. Neutropenic patients had higher prevalence of mucocutaneous infections (47.6% vs 7.14%; P = 0.004). Herpes simplex virus 1 infections occurred only in the neutropenic group (14.3%).ConclusionsPatients with cancer exhibited a high prevalence of bacterial (42.85%), opportunistic (25.7%), and mixed infections (17.14%). Patients with hematological malignancies and neutropenia presented higher frequency of mucocutaneous and herpes simplex virus 1 infections than the nonneutropenic ones.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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