Febrile neutropenia in paediatric oncology

Febrile neutropenia (FN) is a common and dangerous consequence of myelosuppressive chemotherapy but can occur as part of the disease processes. Bacterial bloodstream infection is the most commonly diagnosed cause of febrile neutropenia, with Gram-positive organisms most frequently isolated. However, Gram-negative organisms are becoming more prevalent, with a worrying trend towards resistant organisms. When FN is prolonged, lasting for more than 5 days, there is an increased risk of invasive fungal infections. Prompt recognition, diagnosis and initiation of treatment with broad-spectrum antibiotics are essential to avoid complications and prevent rapid progression to sepsis and possible death. This short article summarises the definition, causes, pathogenesis, applied physiology and management of FN in children.