<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2016-0011_s_001_w2aab3b8c52b1b7b1aab1c15b1Aa"><h3>Background</h3><p>In some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that afebrile neutropenic cancer patients with severe infections have worse outcome as compared to cancer patients with febrile neutropenia.</p></sec><sec id="j_raon-2016-0011_s_002_w2aab3b8c52b1b7b1aab1c15b2Aa"><h3>Patients and methods</h3><p>We retrospectively analyzed all adult cancer patients with chemotherapy-induced neutropenia and severe infection, who were admitted to the Intensive Care Unit at our cancer center between 2000 and 2011. The outcome of interest was 30-day in-hospital mortality rate. Association between the febrile status and in-hospital mortality rate was evaluated by the Fisher’s exact test.</p></sec><sec id="j_raon-2016-0011_s_003_w2aab3b8c52b1b7b1aab1c15b3Aa"><h3>Results</h3><p>We identified 69 episodes of severe neutropenic infections in 65 cancer patients. Among these, 9 (13%) episodes were afebrile. Patients with afebrile neutropenic infection presented with hypotension, severe fatigue with inappetence, shaking chills, altered mental state or cough and all of them eventually deteriorated to severe sepsis or septic shock. Overall 30-day in-hospital mortality rate was 55.1%. Patients with afebrile neutropenic infection had a trend for a higher 30-day in-hospital mortality rate as compared to patients with febrile neutropenic infection (78% <italic>vs</italic>. 52%, p = 0.17).</p></sec><sec id="j_raon-2016-0011_s_004_w2aab3b8c52b1b7b1aab1c15b4Aa"><h3>Conclusions</h3><p>Afebrile cancer patients with chemotherapy-induced neutropenia and severe infections might have worse outcome as compared to cancer patients with febrile neutropenia. Patients should be informed that severe neutropenic infection without fever can occasionally occur during cancer treatment with chemotherapy.</p></sec></abstract>

BackgroundIn some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that afebrile neutropenic cancer patients with severe infections have worse outcome as compared to cancer patients with febrile neutropenia.Patients and methodsWe retrospectively analyzed all adult cancer patients with chemotherapy-induced neutropenia and severe infection, who were admitted to the Intensive Care Unit at our cancer center between 2000 and 2011. The outcome of interest was 30-day in-hospital mortality rate. Association between the febrile status and in-hospital mortality rate was evaluated by the Fisher’s exact test.ResultsWe identified 69 episodes of severe neutropenic infections in 65 cancer patients. Among these, 9 (13%) episodes were afebrile. Patients with afebrile neutropenic infection presented with hypotension, severe fatigue with inappetence, shaking chills, altered mental state or cough and all of them eventually deteriorated to severe sepsis or septic shock. Overall 30-day in-hospital mortality rate was 55.1%. Patients with afebrile neutropenic infection had a trend for a higher 30-day in-hospital mortality rate as compared to patients with febrile neutropenic infection (78% vs. 52%, p = 0.17).ConclusionsAfebrile cancer patients with chemotherapy-induced neutropenia and severe infections might have worse outcome as compared to cancer patients with febrile neutropenia. Patients should be informed that severe neutropenic infection without fever can occasionally occur during cancer treatment with chemotherapy.

Outcome of severe infections in afebrile neutropenic cancer patients

Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana,

Department of Anesthesiology and Intensive Care, Institute of Oncology, Ljubljana,

University of Ljubljana, Medical Faculty, Ljubljana,

Radiology and Oncology

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

{"article-title":"Outcome of severe infections in afebrile neutropenic cancer patients"}

BackgroundIn some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that...

Outcome of severe infections in afebrile neutropenic cancer patients

Article Category: Research Article

Pubblicato online: 10 feb 2016

Pagine: 442 - 448

Ricevuto: 28 ott 2015

Accettato: 05 nov 2015

DOI: https://doi.org/10.1515/raon-2016-0011

© 2016 Radiol Oncol

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.