Infectious Causes of Diarrhea Among Neutropenic Children

Abstract

Background: Intestinal infections are frequently occur among children with cancer who receive chemotherapy. On the other hand, diarrhea is especially common and severe among cancer patients that develop neutropenia, either due to the disease itself or due to the intensive chemotherapy. There are many causes of diarrhea among those patients, but intestinal infections still an important etiology among them.
 Objectives: to study the frequency of diarrhea among neutropenic children, with its infectious etiologies, especially the bacterial, fungal and parasitic causes.
 Type of the study:Cross-sectional study.
 Methods: the study was done in the Oncology Department of Nanakali Hospital for Haematological diseases and malignanciesin Erbil City, on pediatric age group. One hundred six children with cancer were followed up during the period between January – May 2017, of them only 50 patients who full fill the criteria of being (neutropenic, diarrheic, and age < 14 years), and those were regarded as the study group, compared to 20 patients who had the same criteria (diarrheic, and age < 14 years) but notneutropenic.They were investigated for the infectious causes of diarrhea especially bacterial, parasitic, and fungal agents. Data were analyzed statistically using SPSS program and Correlation test was also used. The results were regarded significant with p < 0.05.
 Results: A total of 70 diarrheal episodes in 106 cancer children were detected, 50 of them were neutropenic while 20 were not. Intestinal infections were detected in 62% of the 1st group and in 45% of the 2nd one, while the causes in the remaining cases of diarrhea (38%) cannot be identified. Bacterial pathogens were the main agents that causes diarrhea followed by fungi then parasites with an infectious rates of (28%, 20%, and 14% respectively).
 Conclusions: Diarrhea commonly developed among cancer children with neutropenia. Bacteria are the most incriminated pathogens followed by Candida and parasites. This study noticed the presence of other etiologies for diarrhea beside infectious causes that should be considered and investigated in the future researches and during management of diarrhea in those patients.

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