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febrile neutropenia in emergency room

Sofia Johansson, Lars Henrik Jensen
The purpose of this article is to describe the management of febrile neutropenia in the medical emergency room. Symptoms and signs of inflammation in patients receiving chemotherapy may be blunted or absent and fever may be the only sign of severe infection. Early initiation of empirical antibiotics is essential for the outcome. A beta-lactam antibiotic is the treatment of choice and the regimen should be re-evaluated frequently in absence of clinical improvement. The treating oncologist should always be involved for advice and for assuring adjustments in future chemotherapy...
August 31, 2015: Ugeskrift for Laeger
Natalia M Pittman, Wilma M Hopman, Mihaela Mates
PURPOSE: Curative chemotherapy for breast cancer is associated with significant toxicities including emergency room (ER) visits and hospital admissions (HAs), events that are underreported in clinical trials. This study examined the reasons for, and factors associated with, ER visits and HA after curative chemotherapy for breast cancer in a tertiary Ontario hospital. PATIENTS AND METHODS: A retrospective study of all patients who completed at least one cycle of curative chemotherapy for breast cancer in 2011 and 2012 was conducted...
March 2015: Journal of Oncology Practice
Lindsey Law, Jane Rogers, Cathy Eng
Case Study  Mr. D., a 55-year-old male, presented to the medical oncology service with a diagnosis of stage III adenocarcinoma of the sigmoid colon. He presented 7 weeks post sigmoid colectomy with lymph node resection and was initiated on adjuvant chemotherapy with CAPOX (capecitabine [Xeloda] and oxaliplatin [Eloxatin]). Standard dosing was used: oxaliplatin at 130 mg/m(2) on day 1 and capecitabine at approximately 2,000 mg/m(2)/day (rounded to the nearest 500-mg tablet size) for 14 days on and 7 days off (1 cycle = 21 days)...
May 2014: Journal of the Advanced Practitioner in Oncology
Sapna Oberoi, Renu Suthar, Deepak Bansal, R K Marwaha
Febrile neutropenia is a common emergency encountered in children receiving chemotherapy for a malignancy. Left untreated, it can lead to serious morbidity and mortality. Febrile neutropenia is suspected in any patient on chemotherapy who presents with fever. Prompt evaluation and management by the primary contact pediatrician is essential for a successful outcome. A detailed history and physical examination is warranted to identify source of infection, although two thirds of them may not have localizing symptoms or signs...
February 2013: Indian Journal of Pediatrics
D Szwajcer, P Czaykowski, D Turner
OBJECTIVES: Febrile neutropenia is considered an oncologic emergency, for which prompt initiation of antibiotics is essential. METHODS: We conducted a retrospective cohort study for the 2006 calendar year involving all adult oncology patients presenting with febrile neutropenia to a regional health authority's emergency departments. The objective was to determine the time from triage to antibiotic administration and its impact on patient outcomes. RESULTS: We identified 68 patients presenting with febrile neutropenia, most of whom (76%) were seen in tertiary care centers...
December 2011: Current Oncology
Kay Leonard
PURPOSE: Severe neutropenia and febrile neutropenia (FN) are the major causes of morbidity, treatment interruptions and dose reductions in patients undergoing chemotherapy. The European Oncology Nursing Society (EONS) conducted an European survey to evaluate nurse perspectives on prevention of infection and FN in this setting, and how much they educate their patients about this. A separate survey explored these issues in patients receiving chemotherapy. METHODS: 217 nurse participants were identified by EONS from the membership database and 473 cancer patients who were receiving/had received chemotherapy were identified through patient advocacy groups...
September 2012: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Samart Pakakasama, Kulvadee Surayuthpreecha, Uthen Pandee, Usanarat Anurathapan, Vimolratne Maleewan, Umaporn Udomsubpayakul, Punnee Butthep, Pitak Santanirand, Nongnuch Sirachainan, Suradej Hongeng
BACKGROUND: Patients with febrile neutropenia (FN) may develop severe infection, septic shock, and death. To improve the outcome of pediatric oncology patients with suspected FN, clinical practice guidelines were developed for these patients at the emergency room (ER). The objective of the present study was to evaluate compliance of the clinical practice guidelines for children with cancer presenting with fever to the ER and adverse outcomes after using the guidelines. METHODS: A retrospective cohort study was undertaken of children with cancer presenting with fever to the ER from January 2007 to December 2008 after the clinical guidelines were implemented...
December 2011: Pediatrics International: Official Journal of the Japan Pediatric Society
A I Piqueras Arenas, M C Otero Reigada, D Pérez-Tamarit, F Asensi Botet, N Diosdado Ortín, M Santos Durantez
INTRODUCTION: Varicella is a common, highly contagious disease. It is usually benign but has potentially serious complications. PATIENTS AND METHODS: To assess the clinical characteristics and the associated cost of varicella hospitalization, we reviewed the medical records of children hospitalized for varicella between 2001 and 2004. Children with coincidental varicella hospitalized for a different reason were excluded. RESULTS: Of 1177 children with varicella attended at the emergency room, 101 (8...
August 2005: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Abdullah Büyükçelik, Hakan Akbulut, Bülent Yalçin, Feyyaz Ozdemir, Fikri Içli
Two male patients with high-grade gliomas were treated with subtotal or total resection and radiotherapy followed by a lomustine-containing chemotherapy regimen. Both patients took lomustine at an oral dose of 800 mg over five days instead of their regular doses of 200 and 240 mg. Grade 4 neutropenia and thrombocytopenia developed in both patients within two weeks of the last lomustine dose. One of them was admitted to hospital because of febrile neutropenia. Neutropenia and thrombocytopenia were detected in the other patient when he was examined in the emergency room following a generalized convulsion...
November 2004: Tumori
E Shemesh, I Yaniv, M Drucker, S Hadad, Y Goshen, J Stein, S Ash, S Fisher, R Zaizov
The purpose of this work was to assess the feasibility of home intravenous antibiotic treatment (HIAT) for febrile episodes in immune-compromised (neutropenic, splenectomized), low-risk pediatric patients. Thirty hematology-oncology patients who presented to our emergency room from January 1993 to January 1995 and who suffered from a febrile episode and were considered at low risk for septic complications were immediately discharged on HIAT. Patients were followed for at least 3 weeks after recovery. Patients and parents were retrospectively questioned about adverse effects and about their degree of satisfaction with home treatment...
February 1998: Medical and Pediatric Oncology
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