Objective: Febrile neutropenia (FN) is a major cause of morbidity and mortality in children with hematological malignancies and requires prompt empirical antimicrobial therapy. The study aimed to evaluate clinical characteristics, laboratory findings, microbiological profiles, treatment responses, and outcomes of FN episodes in pediatric patients. Materials and Methods: A retrospective review of 397 FN episodes in 88 children aged 0–18 years treated at Baskent University Hospital was conducted. Clinical findings, laboratory parameters, and microbiological results were analyzed to identify causative organisms and predictors of adverse outcomes. Results: Secondary FN episodes were more likely to persist for seven days or longer and required modification of empirical antibiotic therapy more frequently than primary episodes. Thrombocytopenia, low absolute monocyte counts, and elevated total and direct bilirubin levels were observed more commonly during secondary episodes. Clinically documented infections were identified in more than half of all FN episodes, and microbiological pathogens were isolated in 54.9% of cases. Gram-positive organisms predominated, followed by Gram-negative bacteria. Poor or delayed early response to empirical antibiotic therapy was frequently associated with severe infection and bacteremia. Conclusion: These findings indicate that FN remains a significant clinical challenge in pediatric hematological malignancies. Secondary FN episodes, prolonged neutropenia, thrombocytopenia, elevated bilirubin levels, and inadequate early treatment response were associated with more severe clinical courses. Early recognition of high-risk features and adaptation of empirical therapy based on local microbiological patterns may improve clinical outcomes.
Perk et al. (Sun,) studied this question.