Davis Kimberly, Wilson Shaun
, Clinical Lecturer/Honorary Paediatric Infectious Diseases Registrar, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Conflicts of interest: none declared.
, Paediatric Oncologist, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. Conflicts of interest: none declared.
Paediatr Child Health (Oxford). 2020 Mar;30(3):93-97. doi: 10.1016/j.paed.2019.12.002. Epub 2020 Jan 24.
Febrile neutropenia (FN) is a common and dangerous consequence of myelosuppressive chemotherapy but can occur as part of the disease processes. Bacterial bloodstream infection is the most commonly diagnosed cause of febrile neutropenia, with Gram-positive organisms most frequently isolated. However, Gram-negative organisms are becoming more prevalent, with a worrying trend towards resistant organisms. When FN is prolonged, lasting for more than 5 days, there is an increased risk of invasive fungal infections. Prompt recognition, diagnosis and initiation of treatment with broad-spectrum antibiotics are essential to avoid complications and prevent rapid progression to sepsis and possible death. This short article summarises the definition, causes, pathogenesis, applied physiology and management of FN in children.
发热性中性粒细胞减少症(FN)是骨髓抑制性化疗常见且危险的后果,但也可能作为疾病过程的一部分出现。细菌性血流感染是发热性中性粒细胞减少症最常见的诊断病因,最常分离出革兰氏阳性菌。然而,革兰氏阴性菌正变得越来越普遍,耐药菌的趋势令人担忧。当FN持续时间延长,超过5天时,侵袭性真菌感染的风险会增加。迅速识别、诊断并开始使用广谱抗生素治疗对于避免并发症以及防止迅速进展为败血症和可能的死亡至关重要。这篇短文总结了儿童FN的定义、病因、发病机制、应用生理学和管理。