Study of Clinical and Microbiological Profile of Febrile Neutropenia in Adult Patients in Hematolymphoid Malignancies in Tertiary Care Centre
Authors/Creators
- 1. Junior Resident-3, Department of General Medicine, Government Medical College & Cancer Hospital, Aurangabad, Maharashtra, India
- 2. Associate Professor, Department of General Medicine, Government Medical College & Cancer Hospital, Aurangabad, Maharashtra, India
- 3. Professor & HOD, Department of General Medicine, Government Medical College & Cancer Hospital, Aurangabad, Maharashtra, India
Description
Introduction: Febrile neutropenia is a haematological emergency which develops as a result of treatment of haematological malignancies. The literature shows that life threatening infection is observed in 48 to 60% of patients with febrile Neutropenia. Cancer patients receiving antineoplastic therapy are susceptible to be adversely affected by chemotherapy-induced side effects such as myelosuppression or mucositis, which make them at risk for bacterial and fungal infections. Material and Methods: This was cross sectional, observational, Descriptive study conducted in tertiary care centre & teaching institute. The study period was from March 2019 to March 2021. The present study included 100 patients with adult hemato-lymphoid malignancies who were receiving chemotherapy and who had developed febrile neutropenia. Results: In this study majority of the patients were middle aged. Males were seen to be affected more than female. Fever and weakness was the common presentation of febrile neutropenic patients. A large number of patients were presented with clinical signs and symptoms suggestive of respiratory system involvement. Duration of neutropenia and fever were significantly associated with outcome. Gram negative infections especially pseudomonas aeruginosa species was a common cause of febrile neutropenia. The cases of AML and Hodgkin’s lymphoma were common in the present study. In our study 16% patients died during the course of treatment. Conclusion: Since inflammatory response is muted in neutropenic patients, a fever may be the earliest and the only sign of infection. It is, therefore, critical to recognize fever early in neutropenic patients and to initiate Empirical antibacterial therapy promptly to avoid progression to sepsis syndrome and possibly death.
Abstract (English)
Introduction: Febrile neutropenia is a haematological emergency which develops as a result of treatment of haematological malignancies. The literature shows that life threatening infection is observed in 48 to 60% of patients with febrile Neutropenia. Cancer patients receiving antineoplastic therapy are susceptible to be adversely affected by chemotherapy-induced side effects such as myelosuppression or mucositis, which make them at risk for bacterial and fungal infections. Material and Methods: This was cross sectional, observational, Descriptive study conducted in tertiary care centre & teaching institute. The study period was from March 2019 to March 2021. The present study included 100 patients with adult hemato-lymphoid malignancies who were receiving chemotherapy and who had developed febrile neutropenia. Results: In this study majority of the patients were middle aged. Males were seen to be affected more than female. Fever and weakness was the common presentation of febrile neutropenic patients. A large number of patients were presented with clinical signs and symptoms suggestive of respiratory system involvement. Duration of neutropenia and fever were significantly associated with outcome. Gram negative infections especially pseudomonas aeruginosa species was a common cause of febrile neutropenia. The cases of AML and Hodgkin’s lymphoma were common in the present study. In our study 16% patients died during the course of treatment. Conclusion: Since inflammatory response is muted in neutropenic patients, a fever may be the earliest and the only sign of infection. It is, therefore, critical to recognize fever early in neutropenic patients and to initiate Empirical antibacterial therapy promptly to avoid progression to sepsis syndrome and possibly death.
Files
IJPCR,Vol15,Issue3,Article159.pdf
Files
(394.9 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:b031ee04eafa6e634c43abcf658f5134
|
394.9 kB | Preview Download |
Additional details
Dates
- Accepted
-
2023-03-18
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue3,Article159.pdf
- Development Status
- Active
References
- 1. Taj M, Farzana T, Shah T, Maqsood S, Ahmed SS, Shamsi TS. Clinical and microbiological profile of pathogens in febrile neutropenia in hematologicalmalignancies: A single center prospective analysis. Journal of oncology. 2015 Jan 1; 2015. 2. Karimi F, Ashrafi F, Moghaddas A, Derakhshandeh A. Management of febrile neutropenia: A description of clinical and microbiological findings by focusing on risk factors and pitfalls. J Res Pharm Pract. 2018; 7:147-56. 3. Jacob LA, Lakshmaiah KC, Govindbabu K, Suresh TM, Lokanatha D, Sinha M, et al. Clinical and microbiological profile of febrile Neutropenia in solid tumors and hematological malignancies at a tertiary cancer care center in South India. Indian J Cancer. 2014; 51:464-8. 4. Kapoor R, Simalti AK, Roy S, Agarwal P. Clinicohematological profile of febrile neutropenia in childhood acute leukemia and utility of serum procalcitonin levels in neutropenic patients. Indian J Crit Care Med. 2018; 22:336–339. 5. Villafuerte-Gutierrez P, Villalon L, Losa JE, Henriquez-Camacho C. Treatment of febrile neutropenia and prophylaxis in hematologic malignancies: a critical review and update. Adv Hematol. 2014; 27:1–9. 6. Jamal A, Fatima N, Shaikh S, Kaleem B, Rizvi QA, Zaidi U, Borhany M, Shamsi T. Pattern of Antimicrobial Sensitivity in Microbiologically Documented Infections in Neutropenic Patients with Haematological Malignancies: A single Center Study. Indian journal of microbiology. 2019 Jun;59(2):188-92. 7. Sharma A, Lokeshwar N., Febrile neutropenia in haematological malignancies. J Postgrad Med. 2005; 51: S42–S48. 8. Flowers CR, Seidenfeld J, Bow EJ, Karten C, Gleason C, Hawley DK, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American society of clinical oncology clinical practice guideline. J Clin Oncol. 2013; 31:794-810. 9. Ghosh I, Raina V, Kumar L, Sharma A, Bakhshi S, Thulkar S, Kapil A. Profile of infections and outcome in high-risk febrile neutropenia: experience from a tertiary care cancer center in India. Medical Oncology. 2012 Jun 1; 29(2): 1354-60. 10. Parodi RL, Lagrutta M, Tortolo M, Navall E, Rodríguez MS, Sasia GF, De Candia LF, Gruvman MA, Bottasso O, Greca AA. A multicenter prospective study of 515 febrile neutropenia episodes in Argentina during a 5-year period. PloS one. 2019 Oct 31;14(10):e0224299. 11. Krishnamani K, Gandhi LV, Sadashivudu G, Raghunadharao D. Epedimiologic, clinical profile and factors affecting the outcome in febrile neutropenia. South Asian journal of cancer. 2017 Jan;6(1):25. 12. Kumar A, Suhail M, Maka V, Kumar S, Kilara N. Clinical profile, outcome and application of MASCC scoring in febrile neutropenic patients. Arch Can Res. 2017;5(4):161. 13. Lakshmaiah KC, Malabagi AS, Govindbabu RS, Sinha M, Jayashree RS. Febrile neutropenia in hematological malignancies: clinical and microbiological profile and outcome in high-risk patients. Journal of laboratory physicians. 2015 Jul;7(2):116. 14. Cortés JA, Cuervo S, Gómez CA, Bermúdez D, Martínez T, Arroyo P. Febrile neutropenia in the tropics: A description of clinical and microbiological findings and their impact on inappropriate therapy currently used at an oncological reference center in Colombia. Biomedica. 2013 Mar; 33(1): 70-71.