ABSTRACT
This current retrospective study reviewed 75 febrile neutropenic episodes occurred in children with cancer treated at the Pediatric Oncology Unit of Benha Children Hospital. The aim of this work was to study clinical and laboratory parameters of infection in febrile neutropenic children with cancer as well as the associated risk factors, therapeutic regimens and modification of therapy and their effects on the outcome of cases. We found 31 % of cases have clinically documented infection while 33% have bacteremia at the time of presentation. The lung WGS the most common site of infection [13 % of all cases] and gram-positive bacteria accounted for 63% of culture positive cases. Improvement rate was significantly lower in malnourished group [P<0.05] compared to well-nourished group. Thrombocytopenia was a significant risk factor determining improvement rate. Platelet count <50.000/mm3 significantly decreased the rate of infection control [P<0.05]. Also absolute neutrophilic count [ANC] =/> 500/mm3 had a bad outcome results. Four cases were died from group of ANC =/> 500/mm- and no one was died from other group [P<0.05]. High risk neutropenia [Al-C <1 00/mm3 and > 7 days] showed significantly lower percentage of improvement [P<0.05]. Therapeutic regimen of ceftazidime - amikacin have higher rate of success [P<0.05] Modification therapy with metronidazole, fluconazole or granulocyte stimulating factor have significant good results on rate of improvement of cases [P<0.05].We concluded that fever in neutropenic children with cancer is an alarming sign of infection and empirical antibiotic therapy should started immediately. Infection control and improvement rare are affected significantly by degree and duration of neutropenia, degree of thrombocytopenia, nutritional status and regimen and modification of therapy