Profile and Short Term Outcome of Hospitalized Neutropenic Children

Abstract

BACKGROUND AND OBJECTIVES: Neutrophils constitute an essential part of our immune system against invasive microorganisms. Neutropenia is a frequent problem encountered in hospitalized children with myriad implications on duration of hospital stay as well as outcome. This study was conducted to study clinical prole and short term outcome of hospitalized neutropenic children. METHODS: This observational study was done at our tertiary care level teaching hospital over two years period from April 2018-March 2020. We included 56 hospitalized children aged <15 years with absolute neutrophil count (ANC) <1500/ cu mm. Necessary investigation were done to identify the cause of neutropenia. Clinical features, admission diagnosis, duration of neutropenia, duration of hospital stay, complications and outcome were studied. Such children were followed up for 4 weeks. RESULTS: Mean age was 8.8 years (S.D 2.7 years). Mild neutropenia was seen in 48.2%, moderate neutropenia in 33.9% and severe neutropenia was seen in 17.9% cases. Mean ANC was 1021/cu mm (SD 324) whereas the mean duration of neutropenia was 4.7 days (SD 2.4 days). Infections were the commonest etiology of neutropenia (dengue, malaria & enteric fever were the commonest infections). Thrombocytopenia was seen in 31(55.4%) of such children. Mean duration of thrombocytopenia was 6.24 (SD 2.17) days. Mean & median duration of hospital stay was 8.24(S.D 4.3) days and 7 days respectively. 47 (83.4%) children were discharged and 9 (16.6%) children died. Neutropenia normalized in 48 (85.7%) children by end of rst week. No children had persistent neutropenia during the 4 week follow-up period. CONCLUSION: Infections are the commonest cause of transient neutropenia in hospitalized children with dengue, typhoid and malaria being the common etiologies. The length of hospital stay as well as the duration of neutropenia increased with the severity of neutropenia and there was an inverse relation of these to the age. Our study also shows that most of the episodes of acute transient neutropenia recover without major complications