The patient was continued on ATRIPLA and finished 5 out of 6 cycles of R-CHOP-21 chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone), complicated by multiple episodes of neutropenic fever. After the 3rd cycle, a positron emission tomography/CT scan showed no evidence of active mass lesion or lymphadenopathy. After 10 months of follow-up, the patient continues to dem...

CONTEXT Neutropenia is one of the grave consequences of cancer chemotherapy, and the treatment of neutropenic febrile patients with intravenous (iv) antibiotics has been shown to reduce mortality. Oral therapy could be an alternative approach for selected patients. OBJECTIVES To compare the efficacy of oral antibiotics versus iv antibiotic therapy in febrile neutropenic cancer patients. DAT...

Background: Infections are major cause of morbidity and mortality in children receiving cancer chemotherapy particularly when they are neutropenic, mainly due to immune deficiency. Between 48-60% neutropenic patients with fever have an underlying infection which can often be life threatening. Before putting the child on empiric antimicrobial regimes for FN, it is essential to know the spectrum ...

A 17-year-old man with acute lymphoblastic leukaemia had fever and diarrhoea during a febrile neutropenic episode. A spiral-shaped, Gram-negative anaerobic bacterium was isolated from blood, and confirmed as Anaerobiospirillum succiniciproducens by 16S rRNA sequencing. The patient responded to imipenem.

Background Antimicrobial stewardship in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients remains underutilized in North America. European guidelines advise de-escalation of broad-spectrum therapy after 72 hours in select patients with neutropenic fever of unknown origin. This is not commonplace in the United States, as current guidelines recommend broad-spectrum therapy...

Neutropenic sepsis is a common clinical entity occurring in postchemotherapy patients. Infection may not be the cause of fever in such patients after neutrophil-count recovery. Herein, we present two patients who developed fever during the neutropenic phase of induction chemotherapy and were treated with broad-spectrum antibiotics until they were no longer febrile and had recovered their neutro...

Infectious complications are an important cause of morbidity and mortality in cancer patients, especially those receiving chemotherapy. Furthermore, neutropenia, fever and infection limit the dose-intensity of antineoplastic chemotherapy in cancer patients. Fever without clinical signs of a localized infection is the commonest clinical presentation in neutropenic patients. Early empirical admin...

The discussion by Freifeld and Pizzo is a comprehensive summary of an important recent trend: the attempt to identify low-risk patients with fever and neutropenia and relax their therapy appropriately. It is not surprising that a summary from these authors would be definitive. Dr. Pizzo and his colleagues have defined many central elements of the therapy of fever and neutropenia: that broad-spe...

BACKGROUND Procalcitonin (PCT) has been proposed as a marker of infection and was studied in neutropenic patients. This study investigated its role in non-neutropenic febrile cancer patients (NNCPs). METHODS Between July 2009 and July 2010, a total of 248 NNCPs with fever were studied. PCT was measured in plasma within 24 hours of fever onset and 4 to 7 days thereafter, using a Kryptor system...