Febrile Episodes in Children with Cancer in the United Arab Emirates

Abstract

The febrile episodes encountered in our pediatric oncology unit over a 2-year period were reviewed. A total of 138 febrile episodes were recorded in 59 patients (29 with leukemia and 30 with a solid tumor). There was no difference in the number of episodes between leukemia and solid tumor patients, nor between neutropenic and non-neutropenic patients. The degree of neutropenia was more severe in leukemia patients. A total of 18.8% of the episodes were accompanied by positive blood cultures. Gram-positive bacteria were more frequent than gram-negative bacteria, and there were four anaerobic isolates. Seventeen episodes were accompanied by clinical signs of central venous line (CVL) infection. A total of 70.2% of the episodes resolved with a first-line antibiotic combination of flucloxacillin, piperacillin, and netilmicin, 27.5% required modification of the antibiotic combination, and three patients (5%) died due to gram-negative septicemia. These findings indicate that the pattern of infectious complications in the United Arab Emirates is now similar to that observed in Europe and the United States.

Infectious complications in children with acute lymphoblastic leukemia and T-cell lymphoma – a rationale for tailored supportive care

“…Our data on the correlation of febrile episodes with microbiologically or clinically documented infections and their underlying pathogens were in keeping with the results of earlier studies [11,19,20,23,25,29,31]. Febrile episodes were associated with microbiologically or clinically documented infections in 60% of all cases, high-dose-cytarabine/asparaginase.…”

“…Fever was observed during approximately 24% of all chemotherapy cycles, with a mean total incidence of 2.8 febrile episodes per patient (2.5 febrile episodes per low-risk, 3.0 febrile episodes per high-risk patient). The total incidence of febrile episodes per patient in previous reports ranged from 2.6 to 4.2 [19,23,29]. Higher incidence rates can be partly explained by more aggressive chemotherapy regimens.…”

“…Several earlier studies have already addressed different aspects of this issue [11,19,20,23,25,29,31], but have yielded little information about possible individual risk factors in development of an infection during chemotherapy. Thus, we investigated the incidence of febrile episodes for each course of chemotherapy separately and tried to determine whether some patients had an elevated risk of infectious complications.…”

Nonneutropenic fever in children with cancer: A scoping review of management and outcome

“…A total of 646 titles and abstracts were reviewed, of which 83 full‐text articles were retrieved. From this, 16 relevant articles, describing 15 studies, were identified for inclusion in this review (Figure ) . No dedicated NNF treatment guidelines were identified in this search.…”

Infections during high dose methotrexate therapy in childhood acute lymphoblastic leukemia (ALL)

“…More than half of the patient received antibiotics for 7-10 days. Average length of antibiotic therapy was 8.4 days in a study by Mahmood S et al 31 Rodriguez V et al 32 suggests in their study that it is important in patients apparently responding to antibiotics to continue treatment for a minimum of 7-10 days even if cultures prove sterile; too early cessation of treatment may cause relapse of infection and death.…”