Febrile episodes in childhood malignancies.

The objectives of the present report were to study the site of infections and pathogenic organisms during febrile episodes in different childhood malignant conditions, to correlate febrile episode with Absolute Neutrophil Count (ANC) and to know the sensitivity pattern of bacteria to different antibiotics so as to know the most appropriate antibiotic regimen in these children. The study material comprised of forty two febrile episodes occurring in children aged < 12 years with various malignancies. All the episodes were worked up in detail including complete history, physical examination and relevant hematological, microbiological and radiological investigations. Out of the 42 episodes, 15 (36%) occurred in children with acute leukemias, 20 (48%) in children with lymphomas and 7(17%) in children with solid tumors. 26 (62%) episodes were seen in children during chemotherapy, while 12% each in freshly diagnosed and remision and 14% in relapse cases. 12 (28%) episodes occurred in children with ANC < 500/mm3. 36% were microbiologically confirmed. Klebsiella species was the commonest organism isolated followed by E. coli. Maximum sensitivity (75%) was seen with ciprofloxacin against both Klebsiella species and E.coli.