Ann Pediatr Res | Volume 2, Issue 1 | Research Article | Open Access
Hindié Jade*, Hervouet-Zeiber Catherine, Nguyen Uyen-Phuong, Cummins-McManus Barbara, Tapiero Bruce and Pastore Yves
Department of Pediatrics, Sainte-Justine University Hospital Center, Canada
*Correspondance to: Hindie Jade
Fulltext PDFPreviously healthy children who present with fever and newly-discovered isolated neutropenia are often hospitalized and treated with broad-spectrum antibiotics until final cultures are obtained. While the risk of severe infections has been well studied in febrile patients presenting chemotherapyinduced neutropenia and those with severe congenital neutropenia, the risk of severe bacterial infection in previously healthy children has been poorly evaluated. Through a 6-year retrospective cohort study in a large tertiary-care pediatric center, we reviewed the outcomes of patients with isolated neutropenia and fever. We included children with severe neutropenia, defined as an Absolute Neutrophil Count (ANC) ≤ 0.5 × 10/L. All patients with prior history of neoplasia, chemotherapy, recurrent or chronic neutropenia and all patients under 3 months of age were excluded. Forty-seven children, median age of 1.1 years, were included. Median ANC was 0.2 × 10/L. Median hospital stay was 3 days. A seasonal incidence of febrile neutropenia emerged, likely correlating with viral epidemics. Forty-two patients (89.4%) received a diagnosis of probable viral infection, three (6.4%) had a urinary infection, one (2.1%) had pneumonia, and one (2.1%) had tonsillar abscess. Outcome was favorable for all patients. Blood cultures were negative for all patients. Severe neutropenia with fever should not be an absolute indication for antibiotics and hospitalization in previously healthy children with reassuring physical examination. Physicians should guide their management based upon on usual diagnostic evaluation tools including thorough history, physical exam, imaging and other laboratory investigations.
Jade H, Catherine H-Z, Uyen-Phuong N, Barbara C-M, Bruce T, Yves P. The Risk of Bacteremia in Previously Healthy Children Presenting with Severe Neutropenia and Fever. Ann Pediatr Res. 2018; 2(1): 1010.