Section 17. Infectious Diseases >
Part 1. Principles of Infectious Disease >
Chapter 229. Fever and Infection in the Immunocompromised Patient
Management of Fever in the Neutropenic ChildDavid B. Haslam and Jeffrey Scott Mckinney
Topics Discussed: fever; immunocompromised host, infection in; immunology; infectious diseases; neutropenia; neutropenia, febrile .
Sections: Management of Fever in Solid Organ Transplant Recipients, Outcome of Infection, Prognosis and Outcomes, Prevention of Infection, Vaccination, References.
Excerpt:"Management of fever in the child with profound neutropenia provides
one paradigm for the care of suspected infection in a child with severe
immunocompromise. Obviously, this approach is not universally applicable
to all immunocompromised children, but it includes core concepts
that can be generally applied to children with immune deficit. These
concepts include the association between certain defects of immunity
and propensity for specific infections, empiric therapy choice and
modification, step-wise diagnostic evaluation, treatment duration
decisions, and interval assessment parameters. In the context of antineoplastic therapy, neutropenia is traditionally
defined as an absolute neutrophil count (ANC) <500 cells/mm3,
or as an ANC of 1000 cells/mm3 with a
predicted decrease to <500 cells/mm3.
Quite distinct from the prolonged fever duration required for classic
definitions of fever of unknown origin (FUO), fever is here defined
as a single oral temperature ≥38.3°C (101°F), or
≥38.0°C (100.4°F), for at least 1 hour.1 ..."
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