Lecture 36: Molecular medicine; A case of febrile neurtopenia Flashcards

1
Q

Febrile neutropenia

A
  • Can be caused by chemo?
  • Common in severely neutropenic patients
  • High rates of bactaraemia
  • Infections from endogenous gut and skin (through catheter?) flora
  • Very high mortality in patients with gram- bacteria
  • Improved outcome with empiric antibiotic use
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2
Q

Rigors

A

Uncontrolled prolonged shivering, often in severe infection

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3
Q

Risk on infection if neutrophils <0.1

NOTE not all cancer treatments will cause it this bad, common in haematologic cancer treatment

A

Duration of 1 week- 33% severe infection

Duration of 6 weeks- 100% severe infection

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4
Q

Common infectiou agents in febrile neutropenia

A

Gram + staphylococci and streptococci.

Aerobic gram -ve bacilli (E. Coli, Pseudomonas aeruginosa)

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5
Q

Empiric antibiotic regiment, before known organism

A

Tazocin (piperacillin and tazobactam): Active against almost all aerobic bacteria
+
Gentamicin (aminoglycoside): active against almost all aerobic gram -ve bacilli

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6
Q

Ideas to reduce conseqeunces of febrile neutropenia?

A

Antibiotic prophylaxis- controversial
Haematopoietic growth factors such as G-CSF
Nurse patients in isolation
Reduced intensity of chemo

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