J Pediatr Infect Dis 2021; 16(04): 166-170
DOI: 10.1055/s-0041-1726869
Original Article

Clinical Picture, Outcome, and Risk of Serious Bacterial Infections in Immunocompetent Previously Healthy Neutropenic Children

Esra Arslantas
1  Department of Pediatric Hematology and Oncology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
,
Ali Aycicek
1  Department of Pediatric Hematology and Oncology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
,
Recep Türkoglu
2  Department of Pediatrics, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
,
Tuba Nur Tahtakesen
1  Department of Pediatric Hematology and Oncology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
,
Ezgi Paslı Uysalol
1  Department of Pediatric Hematology and Oncology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
,
Cengiz Bayram
1  Department of Pediatric Hematology and Oncology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
,
Ferhan Akici
1  Department of Pediatric Hematology and Oncology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
,
Kamuran Sanlı
3  Department of Microbiology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
,
Nihal Özdemir
1  Department of Pediatric Hematology and Oncology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
› Author Affiliations

Abstract

Objective In childhood, the cause of neutropenia is a challenging diagnosis with a spectrum of underlying etiologies. This study was performed to investigate the clinical picture and the outcomes associated with the new onset neutropenia in previously healthy children, and to determine the risk of serious bacterial infection (SBI) in those patients.

Methods Patients presenting between January 2018 and September 2018 with an absolute neutrophil count (ANC) <1,500/μL were retrospectively evaluated. Patients with known underlying chronic disease or immunosuppressive conditions were excluded. Neutropenia was categorized into three groups: mild, 1,000–1,500/μL; moderate, 500 to <1,000/μL; and severe <500/μL.

Results A total of 423 patients were investigated. There were 156 (36.9%), 193 (45.6%), and 74 (17.5%) patients in the mild, moderate, and severe groups, respectively. Bacteremia was detected in one (0.02%) patient and SBI in 21 (4.9%) patients. No significant correlation was found between the incidence of SBI and bacterial infection rate among different age groups (p > 0.05). The incidence of SBI varied significantly according to the severity of the neutropenia (p = 0.012) and as the neutropenia became more severe, the incidence of SBI increased (p = 0.015).

Conclusion The clinical outcome of neutropenia in previously healthy and immunocompetent children is generally good with a relatively low incidence of SBI. We suggest that aggressive therapy and frequent follow-up should be reserved for previously healthy neutropenic children with SBI.



Publication History

Received: 16 May 2020

Accepted: 22 February 2021

Publication Date:
21 May 2021 (online)

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