Etiological profile of febrile neutropenia in childhood malignancy

Objective: To study the etiological profile of febrile neutropenia in childhood malignancy.
Methods: Children of either sex under 12 years who with haematological malignancy developed fever were subjected to absolute neutrophil count. Children with ANC less than 1500 are included, they are worked up in detail including complete history, physical examination, haematological profile, radiological investigation as required. Concern to the study was obtained. Investigations like blood culture, urine culture, throat swab, ear swab, CSF study was collected and microorganism isolated was presented as proportions.
Results: 75 children were worked up. Acute lymphoblastic leukemia was the commonest haematological malignancy accounting for 83 % (62 /75) of children recruited followed by Acute Myelogenous Leukemia (13%) and Non Hodgkins lymphoma (4%). Among the 75 cases culture was positive in 45 % (34/75). Fungal growth was positive in 12 % of isolates. Among the organism isolated 82 % (28/34) was from children with Acute lymphoblastic leukemia. 12 % (4/34) from children with Acute Myelogenous Leukemia and 6% (2/34) from children with Non Hodgkins Lymphoma.
Conclusion: Culture positivity is more if the ANC is less than 500. Gram negative organism particularly E.coli was most commonly isolated in malignant children with febrile neutropenia. Amikacin in combination with other drugs would be the first drug choice in the management of suspected febrile neutropenia.