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Importance of fever ill looking and positive c-reactive protein in pediatric hemato-oncology clinic at qrmh

Authors:Fareed Th. Haddad, MD. Maher Kh. Mustafa, MD. Ikhlas J. Katamy, SN.
Int J Biol Med Res. 2012; 3(4): 2459-2463  |  PDF File

Abstract

Abstract: Objective: To evaluate the relevance of fever, ill looking and positive C-reactive protein with sepsis and central line infections in pediatric hemato-oncology clinic. While they are under treatment, that make them immunocompromised. Method: A retrospective revision for 103 pediatric hemato/oncologic patients at Queen Rania Hospital for Children (QRMH) between 1st of February 2011 to 31st January 2012. Out of all pts 67 patients were males and 36 patients were females. With male: female ratio of 1.86: 1. Clinical finding and positive C - reactive protein were our guides to do blood cultures. Samples were taken from central venous line as well as peripheral culture for each patient. Hickman line or portal-catheter was used in our studied patients. Results: Our 103 patients, with male to female ratio of 1: 1.86 were immuno compromised, either due to chemotherapy as found in 88patients, or due to their diseases status; like seen in aplastic anemia (seven patients) and post bone marrow transplantation patients. Out of all 76 patients arrived with ill looking, 91 patients were feverish, 94 were either ill in their looking or fever. Cough was a complaint in 36 patients and Mucositis seen in 8 patients. Lab showed positive C - reactive protein in 84 patients and anemia according to its definition detected in 67 patients; while sever anemia that needs blood transfusion in 37 patients. One positive blood culture (either central or peripheral sample) was found in 19 patient represents 18.4%. All of them were C - reactive protein positive. Recommendations: although septic work up is mandatory for this group of pts but: • Not all feverish and/or ill looking pts give positive blood culture. • Anemic specially sever one may aggravate looking of our pts. • All pts with positive blood culture has positive C- reactive protein.