Protocolo diagnóstico de las complicaciones febriles del paciente neutropénico

Resumo

Infectious complications are a major cause of morbidity and mortality in oncohematological patients, especially during chemotherapy-induced neutropenia. Early empirical administration of broad-spectrum antibiotics is the standard practice in the treatment of febrile neutropenia. We have to make the differential diagnosis with other causes of fever in neutropenic patients (underlying disease, tumor Iysis syndrome, drugs, transfusions, etc) and to evaluate the risk of severe infection complications. A complete medical history with physical examination and basic laboratory tests are neccesary to determine the type of empirical antibiotic treatment (oral versus intravenous), its duration, and if the patient needs to be admitted to the hospital (inpatient versus outpatient treatment). It is also important to investigate the source of infection and to get a microbiological documentation. Infectious complications are a major cause of morbidity and mortality in oncohematological patients, especially during chemotherapy-induced neutropenia. Early empirical administration of broad-spectrum antibiotics is the standard practice in the treatment of febrile neutropenia. We have to make the differential diagnosis with other causes of fever in neutropenic patients (underlying disease, tumor Iysis syndrome, drugs, transfusions, etc) and to evaluate the risk of severe infection complications. A complete medical history with physical examination and basic laboratory tests are neccesary to determine the type of empirical antibiotic treatment (oral versus intravenous), its duration, and if the patient needs to be admitted to the hospital (inpatient versus outpatient treatment). It is also important to investigate the source of infection and to get a microbiological documentation.