Febrile neutropenia in pediatric patients: a diagnostic and therapeutic approach

Abstract

Treatment of patients with neoplastic diseases has improved over the past several decades: a significant reduction in the mortality rate due to cancer has been achieved with the new chemotherapeutic agents and with modern treatment modalities. However, most of these agents produce a profound depression of the immune system thus increasing the susceptibility to infections. Febrile neutropenia is the most common complication in patients being treated for malignant diseases. Forty years ago the association was first established between low neutrophil count, fever and infection; since then, empiric antibiotic therapy has become the cornerstone in the management of this complication. Unfortunately, the long periods of hospital stay necessary for these treatments, besides being expensive, produce important psychological effects on patients and their families. The development of risk-stratification models has allowed the identification of low-risk patients to whom other options may be offered, such as the oral or ambulatory therapy. This review presents up to date concepts on febrile neutropenia in pediatric patients.