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Fungal infections often take place in the setting of prolonged or profound neutropenia after administration of empirical therapy. [[Candidiasis]] may range in severity from mucosal or cutaneous infection to [[septicemia]], [[endocarditis]], or disseminated infection. [[Aspergillus]], on the contrary, typically causes life-threatening infection of the sinuses and lungs, particularly after protracted neutropenia.<ref>{{Cite journal | doi = 10.1093/cid/ciq147 | issn = 1537-6591 | volume = 52 | issue = 4 | pages = 427–431 | last = Freifeld | first = Alison G. | coauthors = Eric J. Bow, Kent A. Sepkowitz, Michael J. Boeckh, James I. Ito, Craig A. Mullen, Issam I. Raad, Kenneth V. Rolston, Jo-Anne H. Young, John R. Wingard, null Infectious Diseases Society of Americaa | title = Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America | journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America | date = 2011-02-15 | pmid = 21205990 }}</ref> | Fungal infections often take place in the setting of prolonged or profound neutropenia after administration of empirical therapy. [[Candidiasis]] may range in severity from mucosal or cutaneous infection to [[septicemia]], [[endocarditis]], or disseminated infection. [[Aspergillus]], on the contrary, typically causes life-threatening infection of the sinuses and lungs, particularly after protracted neutropenia.<ref>{{Cite journal | doi = 10.1093/cid/ciq147 | issn = 1537-6591 | volume = 52 | issue = 4 | pages = 427–431 | last = Freifeld | first = Alison G. | coauthors = Eric J. Bow, Kent A. Sepkowitz, Michael J. Boeckh, James I. Ito, Craig A. Mullen, Issam I. Raad, Kenneth V. Rolston, Jo-Anne H. Young, John R. Wingard, null Infectious Diseases Society of Americaa | title = Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America | journal = Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America | date = 2011-02-15 | pmid = 21205990 }}</ref> | ||
==References== | == References == | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 17:32, 2 March 2015
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Resident Survival Guide |
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Febrile Neutropenia Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: F and N; fever and neutropenia; FN; hot and low; hot leuk; neutropenic fever; neutropenic fever syndrome; neutropenic sepsis
Overview
Bloodstream infections caused by endogenous flora and reactivation of latent infections account for a majority of initial febrile episode in neutropenic patients with cancer.
Causes
| Table 1. Common Bacterial Pathogens in Neutropenic Patients |
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| Gram-Positive Pathogens |
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| Gram-Negative Pathogens |
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Bloodstream infections caused by endogenous flora and reactivation of latent infections account for a majority of initial febrile episode in neutropenic patients with cancer. Common bacterial isolates that cause bacteremia in the setting of neutropenia are listed in Table 1.[1] Certain endogenous microorganisms may be reactivated and exit latency during immunosuppression. These include herpes simplex virus, varicella-zoster virus, Epstein-Barr virus, cytomegalovirus, hepatitis B and C viruses, and Mycobacterium tuberculosis. Exogenous pathogens carried by contaminated blood products, medical equipment and devices, water sources, and health care workers represent less common sources of infection. These include Clostridium difficile, respiratory syncytial virus, vancomycin-resistant enterococci, and other multidrug resistant bacteria.[2]
Fungal infections often take place in the setting of prolonged or profound neutropenia after administration of empirical therapy. Candidiasis may range in severity from mucosal or cutaneous infection to septicemia, endocarditis, or disseminated infection. Aspergillus, on the contrary, typically causes life-threatening infection of the sinuses and lungs, particularly after protracted neutropenia.[3]
References
- ↑ Pagano, L. (2012-05). "A prospective survey of febrile events in hematological malignancies". Annals of Hematology. 91 (5): 767–774. doi:10.1007/s00277-011-1373-2. ISSN 1432-0584. PMID 22124621. Unknown parameter
|coauthors=ignored (help); Check date values in:|date=(help) - ↑ MD, John E. Niederhuber (2013-11-05). Abeloff's Clinical Oncology: Expert Consult Premium Edition - Enhanced Online Features and Print, 5e (5 edition ed.). Philadelphia, Pennsylvania: Saunders. ISBN 9781455728657. Unknown parameter
|coauthors=ignored (help) - ↑ Freifeld, Alison G. (2011-02-15). "Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 Update by the Infectious Diseases Society of America". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (4): 427–431. doi:10.1093/cid/ciq147. ISSN 1537-6591. PMID 21205990. Unknown parameter
|coauthors=ignored (help)