Septicemia and septic shock in pediatric patients: 140 consecutive cases on a pediatric hematology-oncology service Journal Article
| Authors: | Aledo, A.; Heller, G.; Ren, L.; Gardner, S.; Dunkel, I.; McKay, S. W.; Flombaum, C.; Brown, A. E. |
| Article Title: | Septicemia and septic shock in pediatric patients: 140 consecutive cases on a pediatric hematology-oncology service |
| Abstract: | Purpose: This report describes the incidence of septic shock in pediatric hematology-oncology patients with positive blood cultures and investigates parameters of potential use in early diagnosis of gram-negative (GN) bacteremia and septic shock. Patients: In a 12-month period, 140 consecutive episodes of septicemia (135 bacterial and 5 fungal) were seen in 100 patients. The absolute neutrophil count (ANC) was > 500/μl in 89 episodes (65%). Results: Septic shock developed in patients with positive blood cultures with an overall incidence of approximately 19%. Of the 12 bacteremic patients who required transfer to the intensive care unit, 83% had a GN isolate recovered. The incidence of septic shock was not significantly lower in the group of patients with ANC > 500/μl. Low serum bicarbonate correlated with GN infection in patients with bacteremia. Conclusions: GN organisms were the major cause of septic shock in a group of pediatric hematology-oncology patients with positive blood cultures although they were recovered less frequently than gram-positive organisms. In our study, non- neutropenic patients with indwelling catheters were at approximately the same risk for GN shock as neutropenic patients. Monitoring blood carbon dioxide content may be useful in the early diagnosis of GN infection. |
| Keywords: | adolescent; adult; child; child, preschool; survival rate; human cell; neutropenia; cancer risk; neoplasms; monitoring; incidence; childhood cancer; infant; sepsis; bacteremia; leukocyte count; gram-positive bacterial infections; gram negative sepsis; gram-negative bacteria; gram-negative bacterial infections; septicemia; blood culture; septic shock; shock, septic; carbon dioxide tension; humans; human; male; female; priority journal; article; gram-negative sepsis; pediatric malignancies; bicarbonates |
| Journal Title: | Journal of Pediatric Hematology/Oncology |
| Volume: | 20 |
| Issue: | 3 |
| ISSN: | 1077-4114 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1998-05-01 |
| Start Page: | 215 |
| End Page: | 221 |
| Language: | English |
| DOI: | 10.1097/00043426-199805000-00006 |
| PUBMED: | 9628432 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 12 December 2016 -- Source: Scopus |
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