发热性中性粒细胞减少症是儿科血液或实体瘤患者经历的主要感染性并发症之一,which,尽管在诊断和治疗方面取得了进展,仍然与显著的发病率和死亡率相关。这些患者有几个感染的危险因素,其中主要是化疗引起的中性粒细胞减少症,皮肤和粘膜屏障的破坏以及血管内装置的使用。血液和实体瘤患者必须根据患者的特征对发热性中性粒细胞减少症发作进行早期诊断和治疗,以改善其预后。因此,重要的是制定协议,以优化和标准化其管理。此外,合理使用抗生素,仔细调整治疗持续时间和抗菌谱,是解决抗菌药物耐药性增加的关键。本文件的目的,由西班牙儿科传染病学会和西班牙儿科血液学和肿瘤学学会联合开发,为儿科肿瘤和血液病患者发热性中性粒细胞减少症的管理提供共识建议,包括初步评估,逐步治疗,支持性护理和侵袭性真菌感染,每个设施都需要适应其患者的特征和当地的流行病学趋势。
Febrile neutropenia is one of the main infectious complications experienced by paediatric patients with blood or solid tumours, which, despite the advances in diagnosis and treatment, are still associated with a significant morbidity and mortality. These patients have several risk factors for infection, chief of which are chemotherapy-induced neutropenia, the disruption of cutaneous and mucosal barriers and the use of intravascular devices. Early diagnosis and treatment of febrile neutropenia episodes based on the patient\'s characteristics is essential in patients with blood and solid tumours to improve their outcomes. Therefore, it is important to develop protocols in order to optimise and standardise its management. In addition, the rational use of antibiotics, with careful adjustment of the duration of treatment and antimicrobial spectrum, is crucial to address the increase in antimicrobial drug resistance. The aim of this document, developed jointly by the Spanish Society of Pediatric Infectious Diseases and the Spanish Society of Pediatric Hematology and Oncology, is to provide
consensus recommendations for the management of febrile neutropenia in paediatric oncology and haematology patients, including the initial evaluation, the stepwise approach to its treatment, supportive care and invasive fungal infection, which each facility then needs to adapt to the characteristics of its patients and local epidemiological trends.