Clinical Characteristics and Outcomes of Non-Neutropenic Fever in Children with Cancer: An Urban-Single Institution Experience
Journal Title: Vajira Medical Journal: Journal of Urban Medicine - Year 2023, Vol 67, Issue 2
Abstract
OBJECTIVE: To evaluate the clinical characteristics and outcomes of pediatric cancer with non-neutropenic fever (NNF) in pediatric cancer patients in the absence of a central venous catheter. METHODS: This single-center retrospective cohort study enrolled pediatric patients with cancer (age < 18 years) who received chemotherapy treatment at the Department of Pediatrics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, from January 2016 to July 2020. Clinical characteristics and outcomes of NNF episodes were described. Descriptive statistics were analyzed. RESULTS: Fifty-one patients were reviewed, but the 97 NNF episodes were documented from 32 patients. Only One (of the 51 patients) had subcutaneous port. The most frequent cancer diagnosis was acute lymphoblastic leukemia (51%). NNF occurred in 3.8 per 1,000 days of chemotherapy period (95% confidence interval [CI] 3.1–4.6). The most frequently clinically documented infections were respiratory tract infection (35%), urinary tract infection (11%), and gastrointestinal infection (10%). The causative pathogens could not be demonstrated in 67.1% of NNF episodes. The commonly identified pathogens were viruses (12.3%), gram-negative bacteria (10.3%), and gram-positive bacteria (5.2%). Empiric treatment with antibiotic was initiated in 92.8% of the total episodes. Ceftriaxone was the most common antibiotic of choice. Only one episode had a positive hemoculture. Four (4.1%) episodes required intensive care unit admissions, and only one NNF-related mortality due to the human Bocavirus pneumonia and multi-organ failure occurred. The mortality rate of NNF was 3.1%. CONCLUSION: NNF episodes are common and life-threatening complications among pediatric cancer patients and generally lead to hospitalization. The incidence of NNF was 3.8 per 1,000 days of chemotherapy (95% CI 3.1–4.6). The causative pathogen in 67% of NNF episodes was unknown, and the commonly identified pathogens were viruses. However, many patients did not identify any causative bacteria, and they received intravenous antibiotics and were hospitalized. The results of our study suggest that patients with severe symptoms may indicate early evaluation and prompt management for viral infection, especially in a patient with a negative bacterial culture and poor respond to antibiotic treatment. This study reveals baseline information for future cohorts to provide guideline management of this common complication during cancer treatment.
Authors and Affiliations
Oranooj Lertkovit Daranee Isaranimitkul Taweewong Tantracheewathorn
Keywords
Related Articles
- EP ID EP723948
- DOI http://dx.doi.org/10.14456/vmj.2023.11
- Views 59
- Downloads 0
Work Factors related to Sleep Quality among Professional Nurses in the Inpatient Department, Faculty of Medicine Vajira Hospital
Objective: To study sleep quality and work factors that affect sleep quality in professional nurses working in the inpatient units of Faculty of Medicine, Vajira Hospital. Methods: The cross-sectional descriptive study...
The Implementation of the Quality of Life Development Plan for the Elderly in Bangkok Phase II (2018-2021) into Efficacy Implementation
Objectives: (1) study of the quality of life development plan for the elderly in Bangkok Phase II (2018–2021); (2) study of factors affecting on the quality of life development plan for the effective implementation of th...
Epidemiologic Study of Ventilator Associated Pneumonia in Neonatal Intensive Care Unit
Objective: To determine the bacterial pathogens and susceptibility patterns causing ventilator associated pneumonia (VAP) in neonatal intensive care unit (NICU) Methods: Retrospective descriptive study, collected data f...
Level of Knowledge about “Spit Don’t Rinse” Brushing Technique and Influencing Factors among Dental Patients in Vajira Hospital
Objective: This work surveyed the level of knowledge about the “spit don’t rinse” brushing technique and studied the influencing factors among dental patients in Vajira Hospital. Methods: A cross-sectional survey was co...
Relationship between Resilience Quotient and Mental Health Problems in Urban Late Adolescents
Objective: To study the level and relationship of resilience and mental health in urban late adolescents. Method: This is a cross-sectional descriptive study. The participants are undergraduate students in Navamindradhi...