Fever of Unknown Origin in Febrile Leukopenia

Antoniadou, Anastasia; Giamarellou, Helen

doi:10.1016/j.idc.2007.08.008

Cited by 32 publications

(8 citation statements)

References 172 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Elevation in LER, LMR, LBR and LNR values occurred as a result of progressive elevations in mean lymphocytes percentages and reduction in mean absolute eosinophils, monocytes, basophils and neutrophils. This predisposes blood recipients to bacterial invasion and increased proliferation of pathogenic bacterial [35, 36]. Fever is a common symptom of sepsis [37].…”

Section: Discussionmentioning

confidence: 99%

Storage related haematological and biochemical changes in Plasmodium falciparum infected and sickle cell trait donor blood

et al. 2018

View full text Add to dashboard Cite

BackgroundIn sub-Saharan Africa where sickle cell trait (SCT) and malaria is prevalent, significant proportions of blood donors may be affected by one or more of these abnormalities. The haemato-biochemical properties of SCT and asymptomatic malaria in donor blood have not been evaluated. This study evaluated the haemato-biochemical impact of SCT and asymptomatic malaria infections in citrate-phosphate-dextrose-adenine (CPDA-1) stored donor blood units.MethodsFifty-milliliters of sterile CPDA-1 anti-coagulated blood were drained into the sample pouch attached to the main blood bag. Ten units each of sickle cell/malaria negative, sickle cell and malaria positive blood were analyzed. Baseline and weekly haematological profiling and week 1, 3 and 5 concentrations of plasma haemoglobin, % haemolysis, sodium, potassium and chloride and lactate dehydrogenase (LDH) were assayed. Differences between baseline and weekly data were determined using one-way analysis of variance (ANOVA) and Kruskal-Wallis test, whereas differences between baseline parameters and week 1–3 data pairs were determined using paired t-test. P-value < 0.05 was considered statistically significant.ResultsStorage of SCT and malaria infected blood affected all haematological cell lines. In the SCT donors, red blood cells (RBC) (4.75 × 1012/L ± 1.43baseline to 3.49 × 1012/L ± 1.09week-5), haemoglobin (14.45 g/dl ± 1.63baseline to 11.43 g/dl ± 1.69week-5) and haematocrit (39.96% ± 3.18baseline to 33.22% ± 4.12week-5) were reduced. In the asymptomatic malaria group, reductions were observed in RBC (5.00 × 1012/L ± 0.75baseline to 3.72 × 1012/L ± 0.71week-5), haemoglobin (14.73 g/dl ± 1.67baseline to 11.53 g/dl ± 1.62week-5), haematocrit (42.72% ± 5.16baseline to 33.38% ± 5.80week-5), mean cell haemoglobin concentration (35.48 g/dl ± 1.84baseline to 35.01 g/dl ± 0.64week-5) and red cell distribution width coefficient of variation (14.81% ± 1.54baseline to 16.26% ± 1.37week-5). Biochemically, whereas plasma LDH levels significantly increased in asymptomatic malaria blood donors (319% increase at week 5 compared to baseline), SCT blood donors had the most significant increase in plasma potassium levels at week 5 (382% increase). Sodium ions significantly reduced in SCT/malaria negative and sickle cell trait blood at an average rate of 0.21 mmol/L per day. Moreover, elevations in lymphocytes-to-eosinophils and lymphocytes-to-neutrophils ratios were associated with SCT and malaria positive blood whilst elevation lymphocytes-to-basophils ratio was exclusive to malaria positive blood.ConclusionSevere storage lesions were significant in SCT or malaria positive donor blood units. Proper clinical evaluation must be done in prospective blood donors to ensure deferral of such donors.Electronic supplementary materialThe online version of this article (10.1186/s12878-018-0128-x) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Storage related haematological and biochemical changes in Plasmodium falciparum infected and sickle cell trait donor blood

et al. 2018

View full text Add to dashboard Cite

show abstract

“…A neutrophil count of less than 100 cells/mm 3 was classified as severe neutropenia. Fever was defined as axillary temperature > 38.0ºC or axillary temperature of 37.8ºC that persisted for more than one hour (1,6) . …”

Section: Methodsmentioning

confidence: 99%

“…Patients under chemotherapy are susceptible to infections because therapy directly affects the production of neutrophils. Reductions in these cells predisposes the body to bacterial invasion and proliferation, and inhibits the appearance of any inflammatory response (1,2) . Over the last three decades the approach to febrile neutropenia has been based on the early and empirical use of antibiotics, a conduct that has proved to reduce mortality rates (1) .…”

Section: Introductionmentioning

confidence: 99%

“…Recent research indicates that neutropenia is a prevalent complication in immunocompromised patients and is associated with high costs and high morbidity and mortality rates (1) . It is estimated that the incidence of hospitalization for neutropenia is 60,000 cases per year in the U.S. and that the average total cost of hospitalization is greater than US$ 20,000 (2) .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neutropenic patients and their infectious complications at a University Hospital

Lima¹,

França²,

Godoi³

et al. 2013

Revista Brasileira De Hematologia E Hemoterapia

View full text Add to dashboard Cite

Objective The aim of this study was to analyze the characteristics and infectious complications of neutropenic patients in a referral hospital. MethodsA cross-sectional study was carried out between April and September 2008, which enrolled all neutropenic patients identified by daily blood counts in the Universidade Federal de Minas Gerais. Demographic data and information on infections were obtained from the Hospital Infection Control Committee. Statistical analysis was performed using the Statistical Package for Social Sciences. ResultsOne hundred and sixteen patients were followed up during 129 hospitalizations. The patients had a mean age of 48.7 years old. Sixty-four (55.2%) patients were male and 25 (21.6%) died during the follow-up. In 97 (75.2%) of the hospitalizations, patients had episodes of febrile neutropenia. Patients classified as low-risk had a mortality rate of 16.2% (n = 12) vs. 39.1% (n = 9) among high-risk patients (p-value = 0.02). The death rate of the patients who had been submitted to hematopoietic stem cell transplantation was 13.5% (n = 5) vs. 26.7% (n = 16) among patients not submitted to transplantation (p-value = 0.13). Of the 155 infections diagnosed, 45.5% were defined as clinically documented. The etiological agent most frequently isolated was Escherichia coli and the main topography reported was bloodstream infections. The most used antimicrobial agents were cefepime, vancomycin and fluconazole. Approximately 24% of patients evolved with impaired renal function during hospitalization. ConclusionMost reported infections in neutropenic patients were defined as clinically documented, which shows the importance of suspicion in patients without specific signs and symptoms for early diagnosis and the need for the classification of risk for timely interventions.

show abstract

“…Neutropenia is the most critical factor leading to infection in patients with cancer. Empiric treatment with broad‐spectrum antimicrobials should be initiated at the first sign of infection, since delay can lead to increased mortality 10. There are numerous causes for fever in the neutropenic host, although bacterial infection is most common.…”

Section: Neutropenic Fevermentioning

confidence: 99%