Febrile neutropenia in cancer patients is a common complication associated to chemotherapy and can be the first manifestation of a potentially lethal infection. In order to adapt our clinical practice to national clinical guidelines, we performed a retrospective review of clinical charts of all children admitted to the Pediatric Unit of Clinica Davila, from May 1, 2003 to December 31, 2004, with cancer, fever and neutropenia. A total of 57 febrile neutropenic episodes occurred in 25 children and in 44% (25/57) of them an infectious focus could be identified; respiratory infections were the most common (11/25). A microorganism could be identified in 16/57 (x%) of episodes, e.g. 12 recovered from blood cultures (42% coagulase negative Staphylococcus, 17% group viridans Streptococci, 17% Escherichia coli and Enterococcus sp, Candida albicans y Pseudomonas aeruginosa in 8% each one), 3 from a catheter (coagulase negative Staphylococci) and 1 from a bronchoalveolar lavage (Pneumocystis jiroveci). At admission, 63% of children received treatment with 2 antibiotics, mostly ceftazidime and amikacin (39%) and 21% received vancomycin. In 37% of patients therapy required adjustment due to a poor response. Fifty six episodes had a favorable resolution with one patient diying of septic shock. Frequency of microorganism detection, the distribution of species recovered and the favorable resolution are comparable to that reported from industrialized countries.
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