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Infectious Diseases



Febrile Neutropenia


There are no clear, consistent defintions for fever and neutropenia.

Definitions can be quite variable amongst units caring for children with cancer.

However, some academic bodies have issued clear definitions in published guidelines.

The Infectious Diseases Society of America 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer defines fever and neutropenia as follows:

  • Fever is defined as a single oral temperature of 38.3 0C, or 38.0 0C twice at least 1 hour apart. 
    • Rectal temperature is generally not performed on febrile neutropenic patients because of the risk of tearing the rectal mucosa and establishing a potential nidus for disseminated infection.
    • Axillary and tympanic temperatures are also commonly used but lack reliablilty and are not generally recommended.
  • Neutropenia is defined as an absolute neutrophil count (ANC) of less than 500 cells/µL, or less than 1000 cells/µL in a patient anticipated to rapidly become severely neutropenic after a course of chemotherapy.


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