Lecture 36 - febrile neutropenia

Question 1

Acute myeloid leukaemia symptoms/signs

Answer 1

• tiredness
• sever brusing
• unusual bleeding from gums
• low haemoblobin
• lowplatelets
• low nuetrophils

Question 2

What do we do next

Answer 2

• Take a bone marrow examination and look at cells
• can see that there is not normal bone marrow

-had chemotherapy to kill the unusual white blood cells, however also damages lots of other rapidly dividing cells

Question 3

Febrile neutropenia

Answer 3

• Started shivering again, and had a high fever
• WBC was very low
• platelet count wa svery low

-nothing in history suggests site of infection

• however after chemotherpay, this destorys neutrophils and these are needed to fight infection
• can get infection easily when low neutrophols
• dont often show sign where infection is as nuetrophils usualy reuslt in inflamation of an area
• this person had high rate of bacteraemia
• these infections tend to come from endogenous gut and skin flora
• very high mortality in patient with gram negative bacteraemia

-can give antibiotic treatment

Question 4

What is most common cause of death of AML?

what is the most common cause of infection?

Answer 4

infection

=pseudomonas aeruginosa

Question 5

Relationship between amount of white blood cells, and risk of infection

Answer 5

If neutrophils are below 0.1 then very veyr high risk of infection, if tehy are around 5 then not too bad infections

-and if this lasts for a long time, then will get far worse

Question 6

Most common infections-

Answer 6

• lung infections
• mouth infections
• central catheter line infections
• blood infections

Question 7

What antibiotics are usually used?

Answer 7

tazocin - piperacillin adn tazobactam

-both affect almost all aerboic bacteria nad also

gentamicin
-this is for the gram negative bacteria