Frequent Respiratory Viral Infections in Children with Febrile Neutropenia - A Prospective Follow-Up Study

Söderman, Martina; Rhedin, Samuel; Tolfvenstam, Thomas; Rotzén-Östlund, Maria; Albert, Jan; Broliden, Kristina; Lindblom, Anna

Bacterial blood cultures were positive in 13 (15%) of the episodes of febrile neutropenia. Five cultures were excluded from further analysis and not defined as septicemia because they were determined to be either contaminants or of no clinical relevance by the treating clinician and/ or the laboratory: Micrococcus species (n = 1), coagulase-negative staphylococcus (n = 1), Staphylococcus epidermidis (n = 2), and unspecified gram-positive bacteria (n = 1). Eight episodes were therefore considered true septicemia. Of these, five episodes involved only septicemia (6%) ( Table 3 ) (i.e. they tested negative for respiratory viruses by PCR). Three episodes involved co-presence with a respiratory virus and septicemia; gram-positive bacteria (Staphylococcus epidermidis (n = 2) and alpha streptococcus (n = 1)) were detected in all three episodes and one episode was also positive for gram-negative bacteria (Escherichia coli). In all three episodes involving co-presence of respiratory virus and septicemia the patients were being treated for a hematologic malignancy, and all had respiratory symptoms ( Table 1 ). The viruses found in this group were RV (n = 2) and HBoV (n = 1) ( Table 2 ).