Rondinelli et al developed a score for identifying a pediatric patient with chemotherapy-induced febrile neutropenia who is at risk for severe infection. The authors are from Hospital do Cancer A. C. Camargo in Sao Paulo in Brazil.
Criteria for a severe infectious complication:
(1) sepsis and/or shock
(2) bacteremia or fungemia by blood culture
(3) death from infection
Parameters:
(1) age of the patient in years
(2) central venous catheter (CVC)
(3) clinical site of infection identified
(4) body temperature in °C
(5) hemoglobin in g/dL
(6) upper respiratory tract infection (URTI)
|
Parameter |
Finding |
Points |
|
age in years |
<= 5 years of age |
1 |
|
|
> 5 years of age |
0 |
|
central venous catheter |
absent |
0 |
|
|
present |
2 |
|
clinical site of infection |
none |
0 |
|
|
present |
4.5 |
|
body temperature |
<= 38.5°C |
0 |
|
|
> 38.5°C |
1 |
|
hemoglobin |
<= 7 g/dL |
1 |
|
|
> 7 g/dL |
0 |
|
upper respiratory tract infection |
absent |
0 |
|
|
present |
2.5 |
total risk score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the risk of having a severe infectious complication.
|
Total Score |
Risk |
|
< 5.5 |
low |
|
5.5 to 9.0 |
intermediate |
|
> 9.0 |
high |
Specialty: Infectious Diseases, Hematology Oncology
