Viral Infections In Children Receiving Anticancer Chemotherapy

Martine Bouw, Peter Hesseling, Etienne Nel, Estrelita Janse-van Rensburg, Glynn Wessels


OBJECTIVE: To determine the presence of bacterial and viral infectious agents in children with fever during anticancer chemotherapy.

DESIGN: Analysis of data obtained during a prospective cohort study.

SETTING: The pediatric oncology unit of Tygerberg Children’s Hospital, Cape Town.

SUBJECTS: All patients up to the age of 15 years who developed fever secondary to anticancer chemotherapy from February 9th 2000 to April 9th 2001.

OUTCOME MEASURES: Viruses were isolated or antigens detected on venous blood samples, nasopharyngeal aspirates, throat swabs, urine and feces where possible. Blood for aerobic and anaerobic culture was obtained from an indwelling intravenous catheter and/or a peripheral vein.

RESULTS: Thirty-four children were analyzed for a total of 102 febrile episodes. The absolute neutrophil count on admission was below 0.5*109/L in 57 (56%) episodes and thus considered neutropenic. Thirty-five viral isolates were identified in 31 (30%) febrile episodes: HSV-1 (n=14), HSV-2 (n=2), CMV (n=10), rotavirus (n=5), adenovirus (n=2), Para influenza type 3 (n=1) and hepatitis B (n=1). The blood culture was positive in 24 (24%) febrile episodes. Within these, a combined viral and bacterial infection was demonstrated in 6 (6%) episodes. Infections were more frequent in neutropenic compared to non-neutropenic episodes; however, this was not significant.

CONCLUSIONS: Viral infections clearly are an important cause of fever in children receiving anticancer therapy and may occur together with a bacterial infection. Diagnostic tests for viral infections should be used more frequently and could be of considerable value in evaluating fever and establishing appropriate treatment in these patients.

Authors' affiliations

Martine Bouw, Wilhelmina Children's Hospital

Peter Hesseling, Tygerberg Children's Hospital

Etienne Nel, Tygerberg Children's Hospital

Estrelita Janse-van Rensburg, University of Pretoria

Glynn Wessels, Tygerberg Children's Hospital

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cancer; fever; neutropenia; viral infection; bacterial infection; chemotherapy

Cite this article

South African Journal of Child Health 2007;1(4):151.

Article History

Date submitted: 2007-10-21
Date published: 2008-01-23

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