How should immunocompromised pediatric patients with fever be evaluated?

Updated: Jul 23, 2019
  • Author: Hina Z Ghory, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Patients who are absolutely or relatively immunocompromised (eg, patients with underlying malignancy, patients undergoing chemotherapeutic regimens) must be evaluated for possible occult bacterial infection. Fever and neutropenia should be considered, and a consultation with the oncologist may be indicated. [40]

The approach to patients with HIV infection should be aggressive enough to determine presence of serious bacterial illness. History includes the parent’s or patient's knowledge of their level of CD4 cells and viral load. A sepsis workup is usually indicated in HIV-positive patients presenting with fever. Early consultation with the primary care provider or infectious disease specialist is indicated in the care of these patients.


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