61. Neutropenia Management of Fever with neutropenia. It is not uncommon these days for cancer patients to receive their chemotherapy in the community in which they reside. http://www.theberries.ns.ca/Archives/neutropenia.html

Management of Fever with Neutropenia It is not uncommon these days for cancer patients to receive their chemotherapy in the community in which they reside. This means of course, that those of us who treat these patients or who work in the ER will encounter the immune suppressed patient with a fever. As family physicians, we may not have much experience with this circumstance, so it's good to have ready access to guidelines for its' management.The following guidelines are used in our hospital and are the same as those used at the Izaak Walton Killam Children's Hospital in Halifax, Nova Scotia. /L. The infection rate increases gradually as the ANC falls below 0.5 x 10 /L, more sharply as it nears 0.2 x 10 /L and exponentially below 0.2 x 10 /L, it is a good idea to avoid contact with anyone having signs or symptoms of infection, as well as avoiding crowds of people. /L and the patient is in the hospital, the temperature should be taken 4-5 times a day. If the patient is at home, it should be taken if there are any signs or symptoms of infection. /L, and febrile patients with a falling ANC between 1.0 and 0.5 x 10

62. Neutropenia-Associated Infections University of Pennsylvania Medical Center Guidelines for Antibiotic Use. neutropenia AND FEVER. Clinical Setting, Recommendation, Dosage Regimen, http://www.uphs.upenn.edu/bugdrug/antibiotic_manual/neutro.htm

University of Pennsylvania Medical Center Guidelines for Antibiotic Use NEUTROPENIA AND FEVER Clinical Setting Recommendation Dosage Regimen Patient clinically stable Patient clinically unstable cefepime cefepime gentamicin 1 gm IV q 8 hour 1 gm IV q 8 hour consult dosing information at this link If fever persists without an obvious source x 72 hours or clinical deterioration occurs, consider: 1. addition of aminoglycoside (if not already receiving) 2. if perirectal infection or oral abscess, additional anaerobic coverage may be necessary consult dosing information at this link addition of amphotericin B 0.5 to 0.7 mg/kg/d IV ( more information If fever persists or patient continues to deteriorate clinically: consult Infectious Diseases Herpes Simplex Infections gingival stomatitis genital acyclovir or valacyclovir acyclovir or valacyclovir acyclovir 5 mg/kg IV q 8 hour OR valacyclovir 500mg po bid Duration 7-10 days rectal acyclovir or valacyclovir acyclovir 5 mg/kg IV q 8 hour OR valacyclovir 1gm po bid Duration 7-10 days Consider addition of vancomycin if evidence of a gram positive infection present (i.e. warmth, erythema, or tenderness at IV catheter site)

63. Neutropenia Causes neutropenia Causes Agranulocytosis Causes. Book, Home Page. Infection See Infectious Causes of neutropenia. Causes Increased Neutrophil http://www.fpnotebook.com/HEM92.htm

Home About Links Index ... Editor's Choice document.write(code); Advertisement Hematology and Oncology Laboratory Anemia ... Mean Platelet Volume Assorted Pages Acid Phosphatase Complete Blood Count Pancytopenia Hematocrit ... Medication Causes of Neutropenia Neutropenia Causes Agranulocytosis Causes Book Home Page Cardiovascular Medicine Dentistry Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Hematology and Oncology Index Anemia Cancer Coagulopathy Cardiovascular Medicine Dermatology Endocrinology Otolaryngology Examination Gastroenterology Hemoglobin Hemolysis Histiocytosis HIV Infectious Disease Laboratory Leukemia General Pulmonology Lymph Marrow Neurology Obstetrics Orthopedics Pediatrics Pharmacology Platelet Prevention Procedure Psychiatry Rheumatology Sarcoma Surgery Symptom Evaluation Vascular Page Laboratory Index Acid Phosphatase serum Anemia Ferritin Anemia Folate RBC Anemia Iron Serum Anemia Protoporphyrin Anemia Reticulocyte Count Anemia Sucrose Hemolysis Test Anemia TIBC Anemia Transferrin Anemia Transferrin Saturation Cancer Marker Cancer Marker CA125 CBC CBC Pancytopenia CBC Hematocrit CBC Hemoglobin CBC MCHC CBC MCV CBC RBC CBC RBC Morphology CBC RDW CBC WBC CBC WBC Leukocytosis CBC WBC Morphology CBC WBC Basophil

64. Medication Causes Of Neutropenia Medication Causes of neutropenia neutropenia due to Medication. DrugInduced Agranulocytosis. Drug-Induced neutropenia. http://www.fpnotebook.com/HEM185.htm

Home About Links Index ... Editor's Choice document.write(code); Advertisement Hematology and Oncology Pharmacology Anemia ... Laboratory Medication Causes of Neutropenia Lymph Medication Causes of Lymphadenopathy Assorted Pages Chemotherapy Alkylating Agent Antibiotic chemotherapy Antimetabolite Chemotherapy ... Hematology Medications in Pregnancy Medication Causes of Neutropenia Neutropenia due to Medication Drug-Induced Agranulocytosis Drug-Induced Neutropenia Book Home Page Cardiovascular Medicine Dentistry Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Hematology and Oncology Index Anemia Cancer Coagulopathy Cardiovascular Medicine Dermatology Endocrinology Otolaryngology Examination Gastroenterology Hemoglobin Hemolysis Histiocytosis HIV Infectious Disease Laboratory Leukemia General Pulmonology Lymph Marrow Neurology Obstetrics Orthopedics Pediatrics Pharmacology Platelet Prevention Procedure Psychiatry Rheumatology Sarcoma Surgery Symptom Evaluation Vascular Page Pharmacology Index Anemia Anemia B12 Anemia Erythropoietin Anemia Iron Anemia Iron Parenteral Chemotherapy Chemotherapy Alkylating Chemotherapy Antibiotic Chemotherapy Antimetabolite Chemotherapy Hormone Chemotherapy Imuran Chemotherapy Plant Chemotherapy Protocol AC

65. Neutropenia: Patient Information: Arizona Telemedicine Program neutropenia. A. What Is neutropenia? neutropenia is a decreased number of neutrophils in the blood. In addition, neutropenia may be related to alcoholism. http://www.telemedicine.arizona.edu/patient_info/benign_disorders/disorders/neut

Patient Information Resource: Benign Hematologic (Blood) Disorders A collaborative project of the Arizona Telemedicine Program , the Arizona Health Sciences Library and the Arizona Cancer Center See: Neutropenia A. What Is Neutropenia? Neutropenia is a decreased number of neutrophils in the blood. Neutrophils are a type of white blood cell (WBC). Together, the WBCs are responsible for the immune response, the fighting of infection. There are many different kinds of WBCs, each with their own particular action. The neutrophils function by leaving the blood to destroy bacteria and fungi in the cells. Without enough neutrophils to fight these invading cells, infection results. Neutrophils are produced in the bone marrow and removed from the blood by the spleen. Therefore, blood levels can be low because of insufficient production in the marrow, excessive destruction in the blood or cells, or increased removal from the blood by the spleen. B. Causes

66. Neutropenia, Cyclic Cyclic neutropenia is a rare blood disorder characterized by recurrent episodes of abnormally low levels of certain white blood cells (neutrophils) in the body http://www.bchealthguide.org/kbase/nord/nord663.htm

document.write(''); var hwPrint=1; var hwDocHWID="nord663"; var hwDocTitle="Neutropenia, Cyclic"; var hwRank="1"; var hwSectionHWID="nord663"; var hwSectionTitle=""; var hwSource="cn6.0"; var hwProdCfgSerNo="wsh_html_031_s"; var hwDocType="NORD"; National Organization for Rare Disorders, Inc. Neutropenia, Cyclic Important It is possible that the main title of the report is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report. Synonyms CN Cyclic Hematopoiesis Human Cyclic Neutropenia Periodic Neutropenia Disorder Subdivisions None Related Disorders List Information on the following diseases can be found in the Related Disorders section of this report: Neutropenia (General) Severe chronic neutropenia General Discussion Cyclic neutropenia is a rare blood disorder characterized by recurrent episodes of abnormally low levels of certain white blood cells (neutrophils) in the body. Neutrophils are instrumental in fighting off infection by surrounding and destroying bacteria that enter the body. Symptoms associated with cyclic neutropenia may include fever, a general feeling of ill health (malaise), and/or sores (ulcers) of the mucous membranes of the mouth. In most cases, individuals with low levels of neutrophils (neutropenia) are abnormally susceptible to recurrent infections. Symptoms The primary finding associated with cyclic neutropenia is a severe chronic decrease in certain white blood cells (neutrophils). In most cases, episodes of neutropenia recur every 21 days (cyclic) and may last for three to six days. The cycling period usually remains constant and consistent among affected individuals. In addition, abnormal levels of red blood cells that assist in clotting (platelets), immature red blood cells (reticulocytes), and other types of white blood cells (monocytes and eosinophils) may also occur.

67. Febrile Neutropenia Febrile neutropenia. Febrile neutropenia, http://www.rcpa.edu.au/pathman/febrile_.htm

This site has been updated. Please go to www.rcpamanual.edu.au This page will be permanently removed on 30th September 2004. Please update your links. Febrile neutropenia Febrile neutropenia FBC with differential WCC blood culture Bacterial Septicaemia eg Pseudomonas aeruginosa Enterobacter aerogenes Staphylococcus aureus Enterococcus faecalis Pneumonia esp Sputum microscopy and culture Streptococcus pneumoniae Haemophilus influenzae Lung infiltrate, lesion eg Aspergillus sp Bronchial brush, wash: bronchoalveolar lavage if response to appropriate empirical antibiotic regimen has not occurred. Mouth, oesophageal ulceration esp If response to initial therapy is unsatisfactory: endoscopy with biopsy for microscopy, culture for yeasts, viral detection, culture. Candida albicans See Candidiasis Herpes simplex virus See Herpes simplex virus infection Cytomegalovirus See Cytomegalovirus infection Cellulitis eg Aspirate from cellulitic area - microscopy and culture, incl fungal culture.

68. Neutropenia neutropenia. neutropenia, Review clinical features, incl history of exposure to drugs, toxins. See also Febrile neutropenia . Decreased production, Drug reactions, http://www.rcpa.edu.au/pathman/neutrope.htm

This site has been updated. Please go to www.rcpamanual.edu.au This page will be permanently removed on 30th September 2004. Please update your links. Neutropenia Neutropenia Review clinical features, incl history of exposure to drugs, toxins. FBC blood film differential WCC bone marrow aspiration See also Febrile neutropenia Decreased production Drug reactions Predictable eg Usually pancytopenia, rather than isolated neutropenia. Cytotoxic drugs Idiosyncratic eg NSAID Sulphonamides Carbimazole Bone marrow failure Bone marrow failure is usually associated with pancytopenia, rather than isolated neutropenia. Irradiation Bone marrow infiltration Acute leukaemia Myelodysplasia Megaloblastic anaemia Usually pancytopenia, rather than isolated neutropenia. Chronic idiopathic neutropenia Hereditary/constitutional eg Cyclic neutropenia Follow-up FBC differential WCC over time. Schwachman syndrome Associated with Pancreatic insufficiency Chediak-Higashi syndrome See under Immunodeficiency Diamond-Blackfan syndrome Organic acidaemias Increased destruction and/or margination Immune SLE Neutrophil antibodies may be helpful.

69. Neutropenia neutropenia. Blood problems. This leaflet explains briefly how anaemia, neutropenia and thrombocytopenia can affect people with HIV. http://omni.ac.uk/browse/mesh/C0027947L0027947.html

low graphics Neutropenia Blood problems This leaflet explains briefly how anaemia, neutropenia and thrombocytopenia can affect people with HIV. One in a series of leaflets produced by the National AIDS Manual (NAM), a UK community-based information provider, aimed at people with HIV or AIDS. Thrombocytopenia Patient Education Neutropenia HIV ... Severe chronic neutropenia This leaflet, aimed at parents, provides information about Severe Chronic Neutropenia (SCN), a rare disease that affects the white cells in the blood. It explains the diagnosis, effects and treatment. The four major types of SCN: congenital, cyclical, idiopathic and autoimmune, are also defined. Published on the Web by Great Ormond Street Children's Hospital (GOSH) and the Institute of Child Health (ICH). Also available in PDF requiring Adobe Acrobat Reader. Patient Education Handout [Publication Type] Neutropenia Child Last modified: 27 May 2004

70. Supportive Care Treatment - Neutropenia neutropenia. Overview. What is neutropenia? neutropenia refers to the presence of abnormally low levels of neutrophils in the circulating blood. http://www.cancerconsultants.com/patient_new/treatment_article.php?article=suppo

71. Información General Sobre La Atención De Apoyo Treatment - Neutropenia Translate this page neutropenia. Qué es la neutropenia? La neutropenia se conoce como la presencia de niveles anormalmente bajos de neutrófilos en la sangre circulante. http://www.cancerconsultants.com/patient_new/treatment_article.php?article=atenc

72. Expert Advice -- Cyclic Neutropenia Cyclic neutropenia is a disorder in which the number white blood cells drops dramatically in a cyclical pattern usually about every 21 days. http://www.parentsoup.com/experts/ped/qas/0,,200533_416804,00.html

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73. Neutropenia Translate this page neutropenia. 1 - Considerações. neutropenia existe quando a contagem de neutrófilos é inferior a 1500/mcL. Entretanto http://ioh.medstudents.com.br/neutropenia.htm

Neutropenia DROGAS QUE PODEM CAUSAR NEUTROPENIA Sindrome de Felty candida ou aspergillus 3 - Tratamento

74. Neutropenia neutropenia What is neutropenia? If your white blood cell count becomes significantly low, a serious condition called neutropenia (newtro-pee-nee-uh) occurs. http://www.chemotherapysideeffects.ca/neutropenia.html

var left1 = false; var left2 = false; var left3 = false; var left4 = false; var left5 = false; var left6 = false; var left7 = false; var left8 = false; var left9 = false; var left10 = false; var t1 = false; var t2 = false; var t3 = false; var t4 = false; var t5 = false; What is neutropenia? Chemotherapy can affect the bone marrow , where all blood cells are produced. If your white blood cell count becomes significantly low, a serious condition called neutropenia (new-tro-pee-nee-uh) occurs. Neutropenia is the medical word for a low neutrophil (white blood cell) count. Unlike other physical side effects of chemotherapy, neutropenia often has silent symptoms. Unless someone is monitoring your blood counts you will not know if you have developed neutropenia until you have an infection. Of the more common side effects of chemotherapy, neutropenia is the most serious because: If left untreated it may lead to life-threatening infection It may affect your ability to receive chemotherapy as planned (studies have shown that delays and dose reductions of chemotherapy can reduce the chances of long term survival Bonadonna G, Valagussa P, Moliterni A, Zambetti M, Brambilla C. Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: the results of 20 years of follow-up. N Engl J Med. 1995;332:901-906.

75. Cancer And Blood Diseases | White Blood Cell Disorders | Neutropenia White Blood Cell Disorders. Print Format. neutropenia. and skeleton. There are several forms of neutropenia Congenital neutropenia http://www.ucsfhealth.org/childrens/medical_services/cancer/white/conditions/neu

University of California, San Francisco About UCSF Quick Links... Admissions Appointments Billing Calendar Clinical Trials Clinics Conditions and Treatments Contact a Patient Contact Us Directions and Maps For Health Professionals Jobs Make A Donation Medical Dictionary Medical Tests News Patient Profiles Specialized Services UCSF Medical Center Volunteer Services Search Medical Services Cancer and Blood Diseases Topics White Blood Cell Disorders To Visit Us ... Other Resources White Blood Cell Disorders Print Format Neutropenia Signs and Symptoms Diagnosis Treatment Signs and Symptoms Neutropenia causes low levels of neutrophils, a type of white blood cell that destroys bacteria in the blood and helps protect your child from infections. Neutropenia can be a very serious condition because without enough neutrophils, your child is susceptible to bacterial infections that can become life threatening. Among children, this condition has a number of causes, including: Inadequate bone marrow production due to other blood disorders such as aplastic anemia or cancer such as leukemia. Response to radiation therapy or chemotherapy, which destroys white cells. When this occurs, it could delay radiation or chemotherapy.

76. Neutropenia Articles, Support Groups, And Resources neutropenia articles, support groups, and resources for patients from Med Help International (www.medhelp.org). Health neutropenia. Medical http://www.medhelp.org/HealthTopics/Neutropenia.html

[Health Topics A-Z] A B C D ... Z Neutropenia Medical Glossary: NEUTROPENIA Ask The Doctor Forums afebrile neutropenia and neupogen (Breast Cancer Forum) Combating neutropenia, etc. (Ovarian Cancer Forum) low platelet count low white blood cells (Hepatitis Forum) LOW WBC'S (Hepatitis Forum) Support Groups: Neutropenia Support Association, Inc. [Med Help Home] [Library Search] [Medical Forums] ... [Patient Network] Revised: 6/2/2004

77. Neutropenia neutropenia. About 70 neutropenia. If the neutropenia is caused by a viral infection, it goes away when the infection is cured. A http://www.mayoclinic.org/peds-whitecell-rst/neutropenia.html

Home About Mayo Clinic Contact Us Mayo Clinic Locations: Arizona Florida Minnesota Mayo Clinic ... Medical Services Pediatric White Cell Disorders White Cell Disorders in Children Treatment Neutropenia Lymphocytopenia Monocyte Disorders ... Medical Services Neutropenia About 70 percent of white blood cells in the human body are neutrophils, white blood cells that fight fungi and bacteria. Neutrophils mature in the bone marrow for about two weeks before being released to fight infection in the body. They circulate for about six hours, searching for foreign substances to attack. Neutropenia (a decrease in neutrophils) can be caused by a problem in the bone marrow that keeps new cells from being formed, or by a condition that prematurely destroys cells in the bloodstream. Medicine for unrelated medical disorders, other blood cell deficiencies, hereditary diseases, cancers, tuberculosis, vitamin deficiencies, and other conditions can cause neutropenia. If the neutropenia is caused by a viral infection, it goes away when the infection is cured. A condition called chronic benign neutropenia of childhood also usually clears up by itself. Congenital neutropenia is sometimes referred to as Kostmann's syndrome. Treatment for neutropenia depends upon its cause. If the condition does not clear up by itself, the patient may need drugs or other therapies. Drugs typically given include growth factors such as G-CSF (granulocyte colony-stimulating factor) or GM-CSF (granulocyte-macrophage colony-stimulating factor). Autoimmune reactions may be treated by corticosteroids or immunosuppressive therapies. In some cases an enlarged spleen may be surgical removed if it is found to be trapping white blood cells. In rare cases a bone marrow transplant may be appropriate.

78. Barth Syndrome - X-linked Cardiomyopathy And Neutropenia Barth Syndrome X-linked Cardiomyopathy and neutropenia. Richard I. Kelley, MD, PhD. The neutropenia was severe and variable but not truly cyclical. http://www.hopkinsmedicine.org/cmsl/Barth_Summary.html

Barth Syndrome - X-linked Cardiomyopathy and Neutropenia Richard I. Kelley, MD, PhD Division of Metabolism, Kennedy Krieger Institute Department of Pediatrics, Johns Hopkins Medical Institutions History and Overview or " TAZ, " mutations in Barth syndrome was further supported by the finding of disabling mutations of TAZ in 14 additional Barth syndrome families [Johnston et al, 1997]. The recognition of homology of TAZ Clinical Manifestations TAZ Genetic and Molecular Pathology TAZ mutations that yield different effects in different tissues. However, in a detailed study of 14 Barth syndrome families, there was no evident phenotype-genotype correlation [Johnston et al, 1997]. To date, more than 50 different mutations in the TAZ gene have been found, of which 60% are frame-shift, stop, or splice-site mutations predicted to disrupt completely the function of the Barth proteins. Another 30% lead to a change in the charge of the protein. A substantial fraction of the mutations are de novo mutations, in a proportion not inconsistent with the one-third new mutation rate predicted for X-linked recessive diseases (Haldane fraction) (I. Gonzales, R. Kelley, unpublished). Epidemiology Differential Diagnosis Diagnostic Evaluation Prognosis and Complications Management Literature Cited Ades LC, Gedeon AK, Wilson MJ, Latham M, Partington MW, Mulley JC, Nelson J, Lui K, Sillence DO. 1993. Barth syndrome: clinical features and confirmation of gene localisation to distal Xq28. Am J Med Genet 45:327-334.

79. Pharmaceutical Research And Manufacturers Of America New Medicines in Development. neutropenia, ChemotherapyInduced. Complete a new search Drug Name (Proprietary name/Generic name). Indications http://www.phrma.org/newmedicines/newmedsdb/drugs.cfm?indicationcode=Neutropenia

80. Management Of A Patient With Fever And Neutropenia: 2002 IDSA Guidelines Management of a Patient With Fever and neutropenia 2002 IDSA Guidelines CME. Kent Sepkowitz, MD Disclosures Release Date March 10, 2004; Valid for credit http://www.medscape.com/viewprogram/2979

Register Log In June 2, 2004 Management of a Patient With Fever and Neutropenia: 2002 IDSA Guidelines CME Kent Sepkowitz, MD Disclosures Release Date: March 10, 2004 Valid for credit through March 10, 2005 Credits Available Physicians - up to 1.0 AMA PRA category 1 credit(s) This CME activity is based on transcripts and slides of presentations as delivered by the faculty at the "Management of a Patient With Fever and Neutropenia: 2002 IDSA Guidelines" symposium held at the Lakeside Center in Chicago, IL on September 13, 2003. Contents of This CME Activity Management of a Patient With Fever and Neutropenia: 2002 IDSA Guidelines Some Background on Bacteria Case 1 Case 2 Case 3 Conclusions Post Test and Evaluation These educational activities, certified by accredited providers, were not prepared by Medscape's editors, but are made available on our site as a service to our audience. Authors are routinely instructed by the provider to disclose significant financial relationships and mention of investigational drugs and unapproved indications. Medscape has received a fee for posting these activities. Direct questions or comments to: CME@webmd.net

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