PHÂN TÍCH ĐẶC ĐIỂM BỆNH NHÂN UNG THƯ CÓ SỐT HẠ BẠCH CẦU NGHIÊM TRỌNG TRONG THỰC HÀNH LÂM SÀNG TẠI KHOA HỒI SỨC CẤP CỨU BỆNH VIỆN K

Abstract

Objective: To study the clinical and paraclinical characteristics of treatment for neutropenic fever with sepsis. Research subjects and methods: Cross-sectional study on 44 patients diagnosed with febrile neutropenia and sepsis from October 2019 to October 2020. Results: The average age is 45.16 ± 23.78, the male/female ratio is 1.6/1, 88.6% are related to chemotherapy, 70.5% are patients with solid tumors, 29.5% are hematologic cancers. Mucocutaneous, digestive and respiratory symptoms are very common (70-80%). Severe granulocytopenia (grade III, IV) is predominant with 84.1%. Procalcitonin levels are high (average 34.87 ± 43.96) but the relationship with mortality rate is unclear. Blood culture results were 68.2% false negatives, positive for gram-negative and gram-positive bacteria were equally (13.6%), and 4.5% were fungemia. Conclusion: Neutropenic fever has a higher sepsis in solid organ cancers than in hematopoietic cancers. It is almost accompanied by chemotherapy. Symptoms are common in the skin, mucous membranes, digestive and respiratory systems. White blood cell level is often severe reduced. Blood cultures has low positive results, including both Gram-negative; Gram-positive bacteria and fungi.