Rivera-Salgado Daniel, Valverde-Muñoz Kathia, Ávila-Agüero María L
Servicio de Infectología, Hospital Nacional de Niños Carlos Sáenz Herrera, San José, Costa Rica.
Servicio de Hematología, Hospital Nacional de Niños Carlos Sáenz Herrera, San José, Costa Rica.
Rev Chilena Infectol. 2018;35(1):62-71. doi: 10.4067/s0716-10182018000100062.
Febrile neutropenia is a life-threatening condition that requires immediate attention, especially in patients with chemotherapy-related neutropenia. Patients with febrile neutropenia have a much greater risk of developing bacterial disease, and fever may be the only indicator of severe bacterial infection. Adequate management of febrile neutropenia emphasizes early recognition of patients, risk stratification, and antibiotic therapy administration during the first 60 minutes of admission to an emergency room. Not all children with febrile neutropenia carry the same risk of morbidity and mortality, so in recent years, efforts have been made to distinguish between high-risk patients where more aggressive hospital management is required. In children classified as low-risk, outpatient management may be considered initially or after 72 hours, whilst high-risk patients should be hospitalized and managed with parenteral antibiotics.
发热性中性粒细胞减少症是一种危及生命的病症，需要立即引起关注，尤其是在患有化疗相关性中性粒细胞减少症的患者中。发热性中性粒细胞减少症患者发生细菌性疾病的风险要高得多，而发热可能是严重细菌感染的唯一指标。发热性中性粒细胞减少症的充分管理强调对患者的早期识别、风险分层以及在急诊室入院后的头60分钟内给予抗生素治疗。并非所有发热性中性粒细胞减少症儿童都具有相同的发病和死亡风险，因此近年来，人们一直在努力区分需要更积极住院管理的高危患者。在被归类为低风险的儿童中，最初或72小时后可考虑门诊管理，而高危患者应住院并用肠胃外抗生素进行治疗。
