Hypotension (defined as systolic blood pressure <90 mmHg or the need for pressor support to maintain blood pressure) Respiratory failure (defined as arterial oxygen pressure less than 60 mmHg while…
Early onset <28 days Management GI mucositis Chemotherapy/irradiation complicated by OVS or CoNS bacteraemia Pain killers (morphine) and antibiotics Oesophagitis Chemotherapy Antacids Herpes simplex Antiviral prophylaxis Candida spp. Antifungal…
Fig. 15.1 Targets of systemic antifungal agents Clinical outcomes in susceptible isolates are best predicted by the peak serum level to MIC ratio. Serum drug levels are infrequently measured and…
Risk factor for infection Risk category Low High 1. Pretransplant General condition including organ function Performance status Good Poor Renal failure No Yes Diabetes mellitus No Yes Iron stores…
Microorganism Management Coagulase-negative staphylococci Catheter can be removed or retained If removed, systemic antibiotics should be administered for 5–7 days If catheter is retained, treat with a systemic antibiotic and…
Fig. 1.1 Nature of febrile episodes in neutropenic patients 1.4 Microbiologically Documented Infections Microbiologically documented infections also account for 25–30 % of febrile episodes in neutropenic patients (Fig. 1.1). The…
Granulocyte count <500/μl or <1,000/μl with predicted decline to ≤500/μl Single oral temperature of >38.3 °C or ≥38.0 °C × 2 within 12 h or ≥38.0 °C over ≥1 h No obvious…
Bacterial pathogens Streptococcus pneumoniae Haemophilus influenzae Neisseria meningitidis Nocardia species Salmonella species Listeria monocytogenes Campylobacter species Legionella species Capnocytophaga species Mycobacteria Fungal pathogens Aspergillus species Zygomycetes (Mucorales) Fusarium species Scedosporium…
L. monocytogenes a S. pneumoniae Staphylococcus spp. Pseudomonas spp. Gram-negative aerobic bacilli N. meningitidis Candida spp. b Aspergillus spp. Cryptococcus neoformans b Varicella zoster virusc Herpes simplex virusc Cytomegalovirus P….
Duration <1 week: moderate risk >1 week: high risk Absolute neutrophil count (ANC) <1,000/μL: moderate risk <100/μL: high risk However, the term neutropenia is frequently used in clinical practice as…
