Chemotherapy-induced neutropenia (FN) is the most common infectious complication in pediatric oncology. To our knowledge, no pediatric research has been published in Tunisia. The purpose of our study was to describe the features of FN among Tunisian children and to investigate factors correlated with FN. We conducted a prospective study of children with chemotherapy-induced FN at the Department of Pediatric Medicine A of the Tunis Children´s Hospital from July 2019 to December 2019. We recorded 50 episodes of FN in 32 patients whose mean age was 5.3 years (3 months-16 years). We included 26 patients with solid tumors (81%) and six patients with hemopathies (18.7%). The mean time between last treatment and fever onset was 10.67 days. Bacteriological investigation was contributory in 18% of cases and mainly showed gram positive cocci. Therapeutic protocol including 1st line empirical antibiotic therapy (3rd generation cephalosporin with aminoglycoside) was effective in 62% of cases. Mortality rate of patients with FN was 2%. The statistical study did not reveal any factor of correlation with late-onset neutropenia. In conclusion, our results are consistent with literature data on bacteriological documentation and mortality. Our 1st line treatment option based on 3rd generation cephalosporin associated with aminoglycoside was effective in 2/3 of the cases. In the future, oral antibiotics may be considered in patients at low risk for infection.
La localisation mammaire isolée d´un lymphome de Hodgkin est rare. Elle peut prêter à confusion avec les autres néoplasies et affections inflammatoires mammaires. Nous rapportons le cas d´une patiente âgée de 18 ans traitée pour lymphome de Hodgkin à cellularité mixte, qui s´est présenté 6 mois après la rémission complète pour un nodule mammaire inflammatoire gauche. Le bilan anatomopathologique initial a été en faveur d´un abcès mammaire. Les investigations face à l´évolution défavorable malgré une antibiothérapie adaptée ont été en faveur d´une rechute du LH avec une localisation mammaire isolée. La patiente est actuellement sous 4e ligne thérapeutique (polychimiothérapie). Les lymphomes Hodgkiniens mammaires sont connus par leur pronostic défavorable. Les progrès thérapeutiques (thérapie ciblée) peuvent améliorer le devenir des patientes.
Keywords: Febrile neutropenia; chemotherapy; microbiology; pediatric; tumors.
Copyright: Faten Fedhila et al.