Pulmonary Infectious Complications in Children with Hematologic Malignancies and Chemotherapy-Induced Neutropenia
| Autor: | Kleoniki I Athanasiadou, Emmanuel Roilides, Eftychia Athanasiadou, Evgenia Papakonstantinou, Aikaterini Voulgaridou |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class medicine.medical_treatment Population Antibiotics lcsh:Medicine Review Neutropenia chemotherapy 03 medical and health sciences 0302 clinical medicine children Internal medicine medicine cancer 030212 general & internal medicine education Mechanical ventilation education.field_of_study medicine.diagnostic_test business.industry Mortality rate lcsh:R respiratory tract medicine.disease infection febrile neutropenia Bronchoalveolar lavage 030220 oncology & carcinogenesis Chest radiograph business Febrile neutropenia |
| Zdroj: | Diseases, Vol 8, Iss 32, p 32 (2020) Diseases |
| ISSN: | 2079-9721 |
| DOI: | 10.3390/diseases8030032 |
| Popis: | Infections frequently complicate the treatment course in children with hematologic malignancies undergoing chemotherapy. Febrile neutropenia (FN) remains a major cause of hospital admissions in this population, and respiratory tract is often proven to be the site of infection even without respiratory signs and symptoms. Clinical presentation may be subtle due to impaired inflammatory response. Common respiratory viruses and bacteria are widely identified in these patients, while fungi and, less commonly, bacteria are the causative agents in more severe cases. A detailed history, thorough clinical and basic laboratory examination along with a chest radiograph are the first steps in the evaluation of a child presenting signs of a pulmonary infection. After stratifying patient’s risk, prompt initiation of the appropriate empirical antimicrobial treatment is crucial and efficient for the majority of the patients. High-risk children should be treated with an intravenous antipseudomonal beta lactam agent, unless there is suspicion of multi-drug resistance when an antibiotic combination should be used. In unresponsive cases, more invasive procedures, including bronchoalveolar lavage (BAL), computed tomography (CT)-guided fine-needle aspiration or open lung biopsy (OLB), are recommended. Overall mortality rate can reach 20% with higher rates seen in cases unresponsive to initial therapy and those under mechanical ventilation. |
| Databáze: | OpenAIRE |
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