Background: Fever and neutropenia (FN) is a potentially life-threatening
complication of chemotherapy in children with cancer. Aim: Our objectives were
to describe the characteristics of episodes of FN experienced by our patients and
evaluate their outcomes and factors affecting them. Material & Methods: A
prospective observational study was conducted at Pediatric Oncology
Department, South Egypt Cancer Institute, Assiut University. All pediatric patients
≤ 18 years with either hematological or solid tumors admitted with documented
episodes of FN after receiving myelosuppressive chemotherapy were included in
this study between February 2018 and February 2020. Results: 200 episodes of
FN experienced by 125 pediatric cancer patients were included. The median age
was six years; 60% of the patients were boys. FN was more prevalent among
patients with hematological malignancies. Associated comorbidities were
reported in 10.5%. Eighty percent of episodes were stratified as high-risk, with
profound neutropenia reported in 47%. The focus of infection was documented in
82% of episodes. Blood-stream infections were 53.1% for Gram-negative and
24.4% for fungal isolates. Infection-related mortality was reported in 7% of
episodes. Diagnosis, disease status, risk stratification, presence of comorbidity,
and the grade of neutropenia significantly affected the outcome. Conclusion:
Although satisfactory therapeutic interventions for neutropenic patients with
fever, life-threatening resistant bacterial and fungal isolates were reported at high
rates that mandate calling for an urgent review of infection control policy.
Keywords: Fever, Neutropenia, Pediatric, Oncology, South Egypt